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The Elephant Man 

And Other Reminiscences 



The Elephant Man 

and 

Other Reminiscences 



By 

Sir Frederick Treves, Bart. 

G.C.V.O., C.B., LL.D. 

Serjeant-Surgeon to His Majesty the King. 

AiitJwr of ''The Other Side of the Lantern," "The Cradle 
of the Deep," "The Country of the Ring and the Book," 
''Highways and Byways of Dorset," "The Riviera of the 
Corniche Road,'' "The Lake of Geneva," etc. etc. 



CASSELL AND COMPANY, LTD 

London, New York, Toronto and Melbourne 

1923 




First published Februarv 1923 
Reprinted February 1923 



Printed in Great Britain 



Contents 



I. The Elephant Man 

II. The Old Receiving Room . 

III. The Twenty-Krone Piece . 

IV. A Cure for Nerves 

V. Two Women .... 

VI. A Sea Lover .... 

VII. A Case of "Heart Failure" 

VIII. A Restless Night 

IX. In Articulo Mortis 

X. The Idol with Hands of Clay 

XI. Breaking the News 

XII. A Question of Hats . 



I 

39 

59 

67 

91 
III 

121 
135 

155 
181 

199 

213 



The Elephant Man 

And Other Reminiscences 
I 

THE ELEPHANT MAN 

IN the Mile End Road, opposite to the London 
Hospital, there was (and possibly still is) a 
line of small shops. Among them was a vacant 
greengrocer's which was to let. The whole of 
the front of the shop, with the exception of the 
door, was hidden by a hanging sheet of canvas 
on which was the announcement that the Elephant 
Man was to be seen within and that the price of 
admission was twopence. Painted on the canvas 
in primitive colours w^as a life-size portrait of 
the Elephant Man. This very crude production 
depicted a frightful creature that could only have 
been possible in a nightmare. It was the figure 
of a man with the characteristics of an elephant. 
The transfiguration was not far advanced. There 
was still more of the man than of the beast. 
This fact — that it was still human — was the most 



2 The Elephant Man 

repellent attribute of the creature. There was 
nothing about it of the pitiableness of the mis- 
shapened or the deformed, nothing of the 
grotesqueness of the freak, but merely the loath- 
some insinuation of a man being changed into 
an animal. Some palm trees in the background 
of the picture suggested a jungle and might have 
led the imaginative to assume that it was in this 
wild that the perverted object had roamed. 

When I first became aware of this phenomenon 
the exhibition was closed, but a well-informed boy 
sought the proprietor in a public house and I was 
granted a private view on payment of a shilling. 
The shop was empty and grey with dust. Some 
old tins and a few shrivelled potatoes occupied 
a shelf and some vague vegetable refuse the 
window. The light in the place was dim, being 
obscured by the painted placard outside. The 
far end of the shop — where I expect the late 
proprietor sat at a desk — was cut off by a curtain 
or rather bj^ a red tablecloth suspended from a 
cord by a few rings. The room was cold and 
dank, for it was the month of November. The 
year, I might say, was 1884. 

The showman pulled back the curtain and 
revealed a bent figure crouching on a stool and 
covered by a brown blanket. In front of it, on 



The Elephant Man 3 

a tripod, was a large brick heated by a Bunsen 
burner. Over this the creature was huddled to 
warm itself. It never moved when the curtain 
was drawn back. Locked up in an empty shop 
and lit by the faint blue light of the gas jet, 
this hunched-up figure was the embodiment of 
loneliness. It might have been a captive in a 
cavern or a wizard watching for unholy mani- 
festations in the ghostly flame. Outside the sun 
was shining and one could hear the footsteps 
of the passers-by, a tune whistled by a boy 
and the companionable hum of traflBc in the 
road. 

The showman — speaking as if to a dog — called 
out harshly : " Stand up ! " The thing arose 
slowly and let the blanket that covered its head 
and back fall to the ground. There stood re- 
vealed the most disgusting specimen of humanity 
that I have ever seen. In the course of my 
profession I had come upon lamentable deformi- 
ties of the face due to injury or disease, as well 
as mutilations and contortions of the body depend- 
ing upon like causes ; but at no time had I met 
with such a degraded or perverted version of a 
human being as this lone figure displayed. He 
was naked to the waist, his -feet were bare, he 
wore a pair of threadbare trousers that had 



4 The Elephant Man 

once belonged to some fat gentleman's dress 
suit. 

From the intensified painting in the street I 
had imagined the Elephant Man to be of gigantic 
size. This, however, was a little man below the 
average height and made to look shorter by the 
bowing of his back. The most striking feature 
about him was his enormous and misshapened 
head. From the brow there projected a huge 
bony mass like a loaf, while from the back of 
the head hung a bag of spongy, fungous-looking 
skin, the surface of which was comparable to 
brown cauliflower. On the top of the skull were 
a few long lank hairs. The osseous growth on 
the forehead almost occluded one eye. The cir- 
cumference of the head was no less than that of 
the man's waist. From the upper jaw there 
projected another mass of bone. It protruded 
from the mouth like a pink stump, turning the 
upper lip inside out and making of the mouth a 
mere slobbering aperture. This growth from the 
jaw had been so exaggerated in the painting as 
to appear to be a rudimentary trunk or tusk. 
The nose was merely a lump of flesh, only recog- 
nizable as a nose from its position. The face iwas 
no more capable of expression than a block of 
gnarled wood. The back was horrible, because 



The Elephant Man 5 

from it hung, as far down as the middle of the 
thigh, huge, sack-like masses of flesh covered by 
the same loathsome cauliflower skin. 

The right arm was of enormous size and shape- 
less. It suggested the limb of the subject of 
elephantiasis. It was overgrown also with pendent 
masses of the same cauliflower-like skin. The 
hand was large and clumsy — a fin or paddle rather 
than a hand. There was no distinction between 
the palm and the back. The thumb had the 
appearance of a radish, while the fingers might 
have been thick, tuberous roots. As a limb it 
was almost useless. The other arm was remark- 
able by contrast. It was not only normal but 
was, moreover, a delicately shaped limb covered 
w^ith fine skin and provided with a beautiful hand 
which any woman might have envied. From the 
chest hung a bag of the same repulsive flesh. It 
was like a dewlap suspended from the neck of 
a lizard. The lower limbs had the characters of 
the deformed arm. They were unwieldy, dropsical 
looking and grossly misshapened. 

To add a further burden to his trouble the 
wretched man, when a boy, developed hip disease, 
which had left him permanently lame, so that 
he could only walk with a stick. He was thus 
denied all means of escape from his tormentors. 



6 The Elephant Man 

As he told me later, he could never run away. 
One other feature must be mentioned to emphasize 
his isolation from his kind. Although he was 
already repellent enough, there arose from the 
fungous skin-growth with which he was almost 
covered a very sickening stench which was hard 
to tolerate. From the showman I learnt nothing 
about the Elephant Man, except that he was 
English, that his name was John Merrick and 
that he was twenty-one years of age. 

As at the time of my discovery of the Elephant 
Man I was the Lecturer on Anatomy at the 
Medical College opposite, I was anxious to examine 
him in detail and to prepare an account of his 
abnormalities. I therefore arranged with the 
showman that I should interview his strange 
exhibit in my room at the college. I became 
at once conscious of a difficulty. The Elephant 
Man could not show himself in the streets. He 
would have been mobbed by the crowd and seized 
by the police. He was, in fact, as secluded from 
the world as the Man with the Iron Mask. He 
had, however, a disguise, although it was almost 
as startling as he was himself. It consisted of 
a long black cloak which reached to the ground. 
Whence the cloak had been obtained I cannot 
imagine. I had only seen such a garment on 



The Elephant Man 7 

the stage wrapped about the figure of a Venetian 
bravo. The recluse was provided with a pair of 
bag-like slippers in which to hide his deformed 
feet. On his head was a cap of a kind that 
never before was seen. It was black like the 
cloak, had a wide peak, and the general outline 
of a yachting cap. As the circumference of 
Merrick's head was that of a man's waist, the 
size of this headgear may be imagined. From 
the attachment of the peak a grey flannel curtain 
hung in front of the face. In this mask was 
cut a wide horizontal slit through which the 
wearer could look out. This costume, worn by 
a bent man hobbling along with a stick, is prob- 
ably the most remarkable and the most uncanny 
that has as yet been designed. I arranged that 
Merrick should cross the road in a cab, and to 
insure his immediate admission to the college I 
gave him my card. This card was destined to 
play a critical part in Merrick's life. 

I made a careful examination of my visitor 
the result of which I embodied in a paper. ^ I 
made little of the man himself. He was shy, 
confused, not a little frightened and evidently 
much cowed. Moreover, his speech was almost 
unintelligible. The great bony mass that pro- 

i British Medical Journal, Dec, 1886, and April, 1890. 



8 The Elephant Man 

jected from his mouth blurred his utterance and 
made the articulation of certain words impossible. 
He returned in a cab to the place of exhibition, 
and I assumed that I had seen the last of him, 
especially as I found next day that the show had 
been forbidden by the police and that the shop 
was empty. 

I supposed that Merrick was imbecile and had 
been imbecile from birth. The fact that his face 
was incapable of expression, that his speech was 
a mere spluttering and his attitude that of one 
whose mind was void of all emotions and concerns 
gave grounds for this belief. The conviction was 
no doubt encouraged by the hope that his intellect 
was the blank I imagined it to be. That he 
could appreciate his position was unthinkable. 
Here was a man in the heyday of youth who was 
so vilely deformed that everyone he met con- 
fronted him with a look of horror and disgust. 
He was taken about the country to be exhibited 
as a monstrosity and an object of loathing. He 
was shunned like a leper, housed Hke a wild beast, 
and got his only view of the world from a peep- 
hole in a showman's cart. He was, moreover, 
lame, had but one available arm, and could hardly 
make his utterances understood. It was not 
until I came to know that Merrick was highly 



The Elephant Man 9 

intelligent, that he possessed an acute sensibility 
and — worse than all — a romantic imagination 
that I realized the overwhelming tragedy of 
his life. 

The episode of the Elephant Man was, I 
imagined, closed ; but I was fated to meet him 
again — two years later — under more dramatic 
conditions. In England the showman and Merrick 
had been moved on from place to place by the 
police, who considered the exhibition degrading 
and among the things that could not be allowed. 
It was hoped that in the uncritical retreats of 
Mile End a more abiding peace would be found. 
But it was not to be. The official mind there, 
as elsewhere, very properly decreed that the 
public exposure of Merrick and his deformities 
transgressed the limits of decency. The show 
•must close. 

The showman, in despair, fled with his charge 
to the Continent. Whither he roamed at first I 
do not know ; but he came finally to BiTissels. His 
reception was discouraging. Bnissels was firm ; 
the exhibition was banned ; it was brutal, indecent 
and immoral, and could not be permitted within 
the confines of Belgium. Merrick was thus no 
longer of value. He was no longer a source of 
profitable entertainment. He .was a burden. He 



10 The Elephant Man 

must be got rid of. The elimination of Merrick 
was a simple matter. He could offer no resist- 
ance. He was as docile as a sick sheep. The 
impresario, having robbed Merrick of his paltry 
savings, gave him a ticket to London, saw him 
into the train and no doubt in parting condemned 
him to perdition. 

His destination was Liverpool Street. The 
journey maj'^ be imagined. Merrick was in his 
alarming outdoor garb. He would be harried by 
an eager mob as he hobbled along the quay. They 
would run ahead to get a look at him. They 
would lift the hem of his cloak to peep at his 
body. He would try to hide in the train or in 
some dark corner of the boat, but never could he 
be free from that ring of curious eyes or from 
those whispers of fright and aversion. He had 
but a few shillings in his pocket and nothing 
either to eat or drink on the way. A panic-dazed 
dog with a label on his collar would have received 
some sympathy and possibly some kindness. 
Merrick received none. 

What was he to do when he reached London? 
He had not a friend in the world. He knew no 
more of London than he knew of Pekin. How 
could he find a lodging, or what lodging-house 
keeper would dream of taking him in? All he 



The Elephant Man ii 

.wanted was to hide. What most he dreaded were 
the open street and the gaze of his fellow-men. 
If even he crept into a cellar the horrid eyes and 
the still more dreaded whispers would follow him 
to its depths. Was there ever such a home- 
coming ! 

At Liverpool Street he was rescued from the 
crowd by the police and taken into the third-class 
waiting-room. Here he sank on the floor in the 
darkest corner. The police were at a loss what 
to do with him. They had dealt with strange and 
mouldy tramps, but never with such an object as 
this. He could not explain himself. His speech 
was so maimed that he might as well have spoken 
in Arabic. He had, however, something with 
him which he produced with a ray of hope. It 
was my card. 

The card simplified matters. It made it evi- 
dent that this curious creature had an acquaintance 
and that the individual must be sent for. A 
messenger was dispatched to the London Hospital 
which is comparatively near at hand. Fortunately 
I was in the building and returned at once with 
the messenger to the station. In the waiting- 
room I had some difficulty in making a way 
through the crowd, but there, on the floor in the 
corner, was Merrick. He looked a mere heap. 



12 The Elephant Man 

It seemed as if he had been thrown there hke a 
bundle. He was so huddled up and so helpless 
looking that he might have had both his arms and 
his legs broken. He seemed pleased to see me, 
but he was nearly done. The journey and want of 
food had reduced him to the last stage of exhaus- 
tion. The police kindly helped him into a cab, 
and I drove him at once to the hospital. He 
appeared to be content, for he fell asleep almost 
as soon as he was seated and slept to the journey's 
end. He never said a word, but seemed to be 
satisfied that all was well. 

In the attics of the hospital was an isolation 
ward with a single bed. It was used for emergency 
purposes — for a case of delirium tremens, for a 
man who had become suddenly insane or for a 
patient with an undetermined fever. Here the 
Elephant Man was deposited on a bed, was made 
comfortable and was supplied with food. I had 
been guilty of an irregularity in admitting such 
a case, for the hospital was neither a refuge nor 
a home for incurables. Chronic cases were not 
accepted, but only those requiring active treat- 
ment, and Merrick was not in need of such treat- 
ment. I applied to the sympathetic chairman of 
the committee, Mr. Carr Gomm, who not only 
was good enough to approve my action but who 



The Elephant Man 13 

agreed with me that Merrick must not again be 
turned out into the world. 

Mr. Carr Gomm wrote a letter to the Times 
detailing the circumstances of the refugee and 
asking for money for his support. So generous 
is the EngHsh pubUc that in a few days — I think 
in a week — enough money was forthcoming to 
maintain Merrick for life .without any charge 
upon the hospital funds. There chanced to be 
two empty rooms at the back of the hospital which 
were little used. They were on the ground floor, 
were out of the way, and opened upon a large 
courtyard called Bedstead Square, because here 
the iron beds were marshalled for cleaning and 
painting. The front room was converted into a 
bed-sitting room and the smaller chamber into a 
bathroom. The condition of Merrick's skin ren- 
dered a bath at least once a day a necessity, and 
I might here mention that with the use of the 
bath the unpleasant odour to which I have referred 
ceased to be noticeable. Merrick took up his abode 
in the hospital in December, 1886. 

Merrick had now something he had never 
dreamed of, never supposed to be possible — a 
home of his own for life. I at once began to 
make myself acquainted with him and to endeavour 
to understand his mentality. It was a study of 



14 The Elephant Man 

much interest. I very soon learnt his speech so 
that I could talk freely with him. This afforded 
him great satisfaction, for, curiously enough, he 
had a passion for conversation, yet all his life 
had had no one to talk to. I — having then much 
leisure — saw him almost every day, and made a 
point of spending some two hours with him every 
Sunday morning when he would chatter almost 
without ceasing. It was unreasonable to expect 
one nurse to attend to him continuously, but there 
.was no lack of temporary volunteers. As they 
did not all acquire his speech it came about that 
I had occasionally to act as an interpreter. 

I found Merrick, as I have said, remarkably 
intelligent. He had learnt to read and had become 
a most voracious reader. I think he had been 
taught when he was in hospital with his diseased 
hip. His range of books was limited. The Bible 
and Prayer Book he knew intimately, but he had 
subsisted for the most part upon newspapers, or 
rather upon such fragments of old journals as he 
had chanced to pick up. He had read a few 
stories and some elementary lesson books, but 
the delight of his life was a romance, especially a 
love romance. These tales were very real to him, 
as real as any narrative in the Bible, so that he 
would tell them to me as incidents in the lives of 



The Elephant Man 15 

people who had Hved. In his outlook upon the 
world he w^as a child, yet a child with some of 
the tempestuous feelings of a man. He was an 
elemental being, so primitive that he might have 
spent the twenty-three years of his life immured 
in a cave. 

Of his early days I could learn but little. He 
was very loath to talk about the past. It was a 
nightmare, the shudder of .which was still upon 
him. He was born, he believed, in or about 
Leicester. Of his father he knew absolutely 
nothing. Of his mother he had some memory. 
It was very faint and had, I think, been elaborated 
in his mind into something definite. Mothers 
figured in the tales he had read, and he wanted 
his mother to be one of those comfortable lullaby- 
singing persons who are so lovable. In his sub- 
conscious mind there was apparently a germ of 
recollection in which someone figured who had 
been kind to him. He clung to this conception 
and made it more real by invention, for since the 
day when he could toddle no one had been kind 
to him. As an infant he must have been repellent, 
although his deformities did not become gross 
until he had attained his full stature. 

It was a favourite belief of his that his mother 
was beautiful. The fiction was, I am aware, one 



i6 The Elephant Man 

of his own making, but it was a great joy to him. 
His mother, lovely as she may have been, basely 
deserted him .when he was very small, so small 
that his earliest clear memories were of the work- 
house to which he had been taken. Worthless 
and inhuman as this mother ,was, he spoke of her 
with pride and even with reverence. Once, 
when referring to his own appearance, he said : 
"It is very strange, for, you see, mother was so 
beautiful." 

The rest of Merrick's life up to the time that 
I met him at Liverpool Street Station was one 
dull record of degradation and squalor. He was 
dragged from town to town and from fair to fair 
as if he were a strange beast in a cage. A dozen 
times a day he would have to expose his nakedness 
and his piteous deformities before a gaping crowd 
who greeted him with such mutterings as "Oh! 
what a horror! What a beast! " He had had 
no childhood. He had had no boyhood. He had 
never experienced pleasure. He knew nothing of 
the joy of Fiving nor of the fun of things. His 
sole idea of happiness was to creep into the dark 
and hide. Shut up alone in a booth, awaiting the 
next exhibition, how mocking must have sounded 
the laughter and merriment of the boys and girls 
outside who were enjoying the " fun of the fair " ! 



The Elephant Man 17 

He had no past to look back upon and no future 
to look forward to. At the age of twenty he 
was a creature without hope. There was nothing 
in front of him but a vista of caravans creeping 
along a road, of rows of glaring show tents and 
of circles of staring eyes with, at the end, the 
spectacle of a broken man in a poor law infirmary. 
Those who are interested in the evolution of 
character might speculate as to the effect of this 
brutish life upon a sensitive and intelligent man. 
It would be reasonable to surmise that he would 
become a spiteful and malignant misanthrope, 
swollen with venom and filled with hatred of his 
fellow-men, or, on the other hand, that he would 
degenerate into a despairing melancholic on the 
verge of idiocy. Merrick, how^ever, was no such 
being. He had passed through the fire and 
had come out unscathed. His troubles had en- 
nobled him. He showed himself to be a gentle, 
affectionate and lovable creature, as amiable as 
a happy .woman, free from any trace of cynicism 
or resentment, without a grievance and without 
an unkind word for anyone. I have never heard 
him complain. I have never heard him deplore 
his ruined life or resent the treatment he had re- 
ceived . at the hands of callous keepers. His 
journey through life had been indeed along a via 



i8 The Elephant Man 

dolorosa, the road had been uphill all the way, 
and now, when the night was at its blackest and 
the way most steep, he had suddenly found him- 
self, as it were, in a friendly inn, bright with light 
and warm with welcome. His gratitude to those 
about him was pathetic in its sincerity and 
eloquent in the childlike simplicity with which it 
was expressed. 

As I learnt more of this primitive creature I 
found that there were two anxieties which were 
prominent in his mind and which he revealed to 
me with diffidence. He was in the occupation of 
the rooms assigned to him and had been assured 
that he would be cared for to the end of his days. 
This, however, he found hard to realize, for he 
often asked me timidly to what place he would 
next be moved. To understand his attitude it is 
necessary to remember that he had been moving 
on and moving on all his life. He knew no other 
state of existence. To him it was normal. He 
had passed from the workhouse to the hospital, 
from the hospital back to the workhouse, then from 
this town to that town or from one showman's 
caravan to another. He had never known a home 
nor any semblance of one. He had no possessions. 
His sole belongings, besides his clothes and some 
books, were the monstrous cap and the cloak. He 



The Elephant Man 19 

was a wanderer, a pariah and an outcast. That his 
quarters at the hospital were his for life he could 
not understand. He could not rid his mind of 
the anxiety which had pursued him for so many 
years — where am I to be taken next? 

Another trouble was his dread of his fellow- 
men, his fear of people's eyes, the dread of being 
always stared at, the lash of the cruel mutterings 
of the crowd. In his home in Bedstead Square he 
was secluded ; but now and then a thoughtless 
porter or a wardmaid would open his door to let 
curious friends have a peep at the Elephant Man. 
It therefore seemed to him as if the gaze of the 
world followed him still. 

Influenced by these two obsessions he became, 
during his first few weeks at the hospital, curiously 
uneasy. At last, with much hesitation, he said 
to me one day : " When I am next moved can I 
go to a blind asylum or to a lighthouse? " He 
had read about blind asylums in the newspapers 
and was. attracted by the thought of being among 
people who could not see. The lighthouse had 
another charm. It meant seclusion from the 
curious. There at least no one could open a door 
and peep in at him. There he would forget that 
he had once been the Elephant Man. There he 
would escape the vampire showman. He had never 



20 The Elephant Man 

seen a lighthouse, but he had come upon a picture 
of the Eddystone, and it appeared to him that this 
lonely column of stone in the waste of the sea was 
such a home as he had longed for. 

I had no great difficulty in ridding Merrick's 
mind of these ideas. I wanted him to get accus- 
tomed to his fellow-men, to become a human being 
himself and to be admitted to the communion of 
his kind. He appeared day by day less frightened, 
less haunted looking, less anxious to hide, less 
alarmed when he saw his door being opened. He 
got to know most of the people about the place, 
to be accustomed to their comings and goings, and 
to realize that they took no more than a friendly 
notice of him. He could only go out after dark, 
and on fine nights ventured to take a walk in 
Bedstead Square clad in his black cloak and his 
cap. His greatest adventure was on one moonless 
evening when he walked alone as far as the hospital 
garden and back again. 

To secure Merrick's recovery and to bring him, 
;as it were, to life once more, it was necessary that 
he should make the acquaintance of men and 
women who would treat him as a normal and 
intelligent young man and not as a monster of 
deformity. Women I felt to be more important 
than men in bringing about his transformation. 



The Elephant Man 21 

Women were the more frightened of him, the 
more disgusted at his appearance and the more apt 
to give way to irrepressible expressions of aversion 
when they came into his presence. Moreover, 
Merrick had an admiration of women of such a 
kind that it attained almost to adoration. This 
was not the outcome of his personal experience. 
They were not real women but the products of 
his imagination. Among them was the beautiful 
mother surrounded, at a respectful distance, by 
heroines from the many romances he had read. 

His first entry to the hospital was attended by 
a regrettable incident. He had been placed on 
the bed in the little attic, and a nurse had been 
instructed to bring him some food. Unfortunately 
she had not been fully informed of Merrick's un- 
usual appearance. As she entered the room she 
saw on the bed, propped up by white pillows, a 
monstrous figure as hideous as an Indian idol. She 
at once dropped the tray she was carrying and fled, 
with a shriek, through the door. Merrick was too 
weak to notice much, but the experience, I am 
afraid, was not new to him. 

He was looked after by volunteer nurses whose 
ministrations were somewhat formal and con- 
strained. Merrick, no doubt, was conscious that 
their service was purely official, that they were 



22 The Elephant Man 

merely doing what they ,were told to do and that 
they were acting rather as automata than as 
women. They did not help him to feel that he 
was of their kind. On the contrary they, without 
knowing it, made him aware that the gulf of 
separation was immeasurable. 

Feeling this, I asked a friend of mine, a young 
and pretty widow, if she thought she could enter 
Merrick's room with a smile, wish him good 
morning and shake him by the hand. She said 
she could and she did. The effect upon poor 
Merrick was not quite what I had expected. As 
he let go her hand he bent his head on his knees 
and sobbed until I thought he would never cease. 
The interview was over. He told me afterwards 
that this was the first woman who had ever smiled 
at him, and the first woman, in the whole of his 
life, who had shaken hands with him. From this 
day the transformation of Merrick commenced and 
he began to change, little by little, from a hunted 
thing into a man. It was a wonderful change to 
witness and one that never ceased to fascinate me. 

Merrick's case attracted much attention in the 
papers, with the result that he had a constant 
succession of visitors. Everybody wanted to see 
him. He must have been visited by almost every 
lady of note in the social world. They were all 



The Elephant Man 23 

good enough to welcome him with a smile and to 
shake hands with him. The Merrick whom I had 
found shivering behind a rag of a curtain in an 
empty shop was now conversant with duchesses and 
countesses and other ladies of high degree. They 
brought him presents, made his room bright with 
ornaments and pictures, and, what pleased him 
more than all, supplied him with books. He soon 
had a large library and most of his day was spent 
in reading. He was not the least spoiled ; not the 
least puffed up ; he never asked for anything ; never 
presumed upon the kindness meted out to him, 
and was always humbly and profoundly grateful. 
Above all he lost his shyness. He liked to see his 
door pushed open and people to look in. He 
became acquainted with most of the frequenters 
of Bedstead Square, would chat with them at 
his window and show them some of his choicest 
presents. He improved in his speech, although to 
the end his utterances were not easy for strangers 
to understand. He was beginning, moreover, to 
be less conscious of his unsightliness, a little 
disposed to think it was, after all, not so very 
extreme. Possibly this was aided by the circum- 
stance that I would not allow a mirror of any 
kind in his room. 

The height of his social development was 



24 The Elephant Man 

reached on an eventful day when Queen Alexandra 
— then Princess of Wales — came to the hospital 
to pay him a special visit. With that kindness 
which has marked every act of her life, the Queen 
entered Merrick's room smiling and shook him 
warmly by the hand. Merrick was transported 
with delight. This was beyond even his most 
extravagant dream. The Queen has made many 
people happy, but I think no gracious act of hers 
has ever caused such happiness as she brought into 
Merrick's room when she sat by his chair and 
talked to him as to a person she was glad to see. 
Merrick, I may say, was now one of the most 
contented creatures I have chanced to meet. More 
than once he said to me : *' I am happy every 
hour of the day." This was good to think upon 
when I recalled the half-dead heap of miserable 
humanity I had seen in the corner of the waiting- 
room at Liverpool St set. Most men of Merrick's 
age would have expressed their joy and sense of 
contentment by singing or whistling when they 
were alone. Unfortunately poor Merrick's mouth 
was so deformed that he could neither whistle nor 
sing. He was satisfied to express himself by 
beating time upon the pillow to some tune that 
was ringing in his head. I have many times found 
him so occupied when I have entered his room 



The Elephant Man 25 

unexpectedly. One thing that always struck me 
as sad about Merrick was the fact that he could 
not smile. Whatever his delight might be, his 
face remained expressionless. He could weep but 
he could not smile. 

The Queen paid Merrick many visits and sent 
him every year a Christmas card with a message 
in her own handwriting. On one occasion she 
sent him a signed photograph of herself. Merrick, 
quite overcome, regarded it as a sacred object 
and would hardly allow me to touch it. Pie cried 
over it, and after it was framed had it put up in 
his room as a kind of ikon. I told him that he 
must write to Her Royal Highness to thank her 
for her goodness. This he was pleased to do, as 
he was very fond of writing letters, never before 
in his life having had anyone to write to. I 
allowed the letter to be dispatched unedited. It 
began "My dear Princess" and ended "Yours 
very sincerely." Unorthodox as it was it was 
expressed in terms any courtier would have envied. 

Other ladies followed the Queen's gracious 
example and sent their photographs to this de- 
lighted creature who had been all his life despised 
and rejected of men. His mantelpiece and table 
became so covered with photographs of handsome 
ladies, with dainty knicknacks and pretty trifles 



26 The Elephant Man 

that they may almost have befitted the apartment 
of an Adonis-Uke actor or of a famous tenor. 

Through all these bewildering incidents and 
through the glamour of this great change Merrick 
still remained in man}^ ways a mere child. He 
had all the invention of an imaginative boy or girl, 
the same love of " make-believe," the same instinct 
of "dressing up " and of personating heroic and 
impressive characters. This attitude of mind was 
illustrated by the following incident. Benevolent 
visitors had given me, from time to time, sums of 
money to be expended for the comfort of the 
ci-devant Elephant Man. When one Christmas 
was approaching I asked Merrick what he would 
like me to purchase as a Christmas present. He 
rather startled me by saying shyly that he would 
like a dressing-bag with silver fittings. He had 
seen a picture of such an article in an advertise- 
ment which he had furtively preserved. 

The association of a silver-fitted dressing-bag 
with the poor wretch wTapped up in a dirty blanket 
in an empty shop was hard to comprehend. I 
fathomed the mystery in time, for Merrick made 
little secret of the fancies that haunted his boyish 
brain. Just as a small girl with a tinsel coronet 
and a window curtain for a train will realize the 
conception of a countess on her way to court, so 



The Elephant Man 27 

Merrick loved to imagine himself a dandy and a 
young man about town. Mentally, no doubt, he 
had frequently "dressed up" for the part. He 
could "make-believe" with great effect, but he 
wanted something to render his fancied character 
more realistic. Hence the jaunty bag which was 
to assume the function of the toy coronet and the 
window curtain that could transform a mite with 
a pigtail into a countess. 

As a theatrical "property" the dressing-bag 
was ingenious, since there was little else to give 
substance to the transformation. Merrick could 
not wear the silk hat of the dandy nor, indeed, 
any kind of hat. He could not adapt his body 
to the trimly cut coat. His deformity was such 
that he could wear neither collar nor tie, while 
in association with his bulbous feet the young 
blood's patent leather shoe was unthinkable. 
What was there left to make up the character? 
A lady had given him a ring to wear on his 
undeformed hand, and a noble lord had presented 
him with a very stylish walking-stick. But these 
things, helpful as they were, were hardly sufficing. 

The dressing-bag, however, was distinctive, was 
explanatory and entirely characteristic. So the 
bag was obtained and Merrick the Elephant Man 
became, in the seclusion of his chamber, the 



28 The Elephant Man 

Piccadilly exquisite, the young spark, the gallant, 
the "nut." When I purchased the article I 
realized that as 'Merrick could never travel he could 
hardly want a dressing-bag. He could not use 
the silver-backed brushes and the comb because 
he had no hair to brush. The ivory-handled razors 
were useless because he could not shave. The 
deformity of his mouth rendered an ordinary 
toothbrush of no avail, and as his monstrous lips 
could not hold a cigarette the cigarette-case was a 
mockery. The silver shoe-horn would be of no 
service in the putting^ on of his ungainly slippers, 
while the hat-brush was quite unsuited to the 
peaked cap with its visor. 

Still the bag was an emblem of the real swell 
and of the knockabout Don Juan of whom he had 
read. So every day Merrick laid out upon his 
table, with proud precision, the silver brushes, the 
razors, the shoe-horn and the silver cigarette-case 
which I had taken care to fill with cigarettes. The 
contemplation of these gave him great pleasure, 
and such is the power of self-deception that they 
convinced him he was the " real thing." 

I think there was just one shadow in Merrick's 
life. As I have already said, he had a lively 
imagination ; he was romantic ; he cherished an 
emotional regard for women and his favourite 



The Elephant Man 29 

pursuit was the reading of love stories. He fell 
in love — in a humble and devotional way — with, 
I think, every attractive lady he saw. He, no 
doubt, pictured himself the hero of many a 
passionate incident. His bodily deformity had 
left unmarred the instincts and feehngs of his 
years. He was amorous. He would like to have 
been a lover, to have walked with the beloved object 
in the languorous shades of some beautiful garden 
and to have poured into her ear all the glowing 
utterances that he had rehearsed in his heart. And 
yet — the pity of it ! — imagine the feelings of such 
a youth when he saw nothing but a look of horror 
creep over the face of every girl whose e5''es met 
his. I fancy when he talked of life among the 
blind there was a half-formed idea in his mind that 
he might be able to win the affection of a woman 
if only she were without eyes to see. 

As Merrick developed he began to display 
certain modest ambitions in the direction of im- 
proving his mind and enlarging his knowledge of 
the world. He was as curious as a child and as 
eager to learn. There were so many things he 
wanted to know and to see. In the first place he 
was anxious to view the interior of what he called 
" a real house," such a house as figured in many 
of the tales he knew, a house with a hall, a drawing- 



30 The Elephant Man 

room where guests were received and a dining-room 
with plate on the sideboard and with easy chairs 
into which the hero could ' ' fling himself. ' ' The 
workhouse, the common lodging-house and a 
variety of mean garrets were all the residences he 
knew. To satisfy this wish I drove him up to my 
small house in Wimpole Street. He was absurdly 
interested, and examined everything in detail and 
with untiring curiosity. I could not show him the 
pampered menials and the powdered footmen of 
whom he had read, nor could I produce the white 
marble staircase of the mansion of romance nor 
the gilded mirrors and the brocaded divans which 
belong to that style of residence. I explained 
that the house was a modest dwelling of the Jane 
Austen type, and as he had read "Emma" he 
was content. 

A more burning ambition of his was to go to 
the theatre. It was a project very difficult to 
satisfy. A popular pantomime was then in pro- 
gress at Drury Lane Theatre, but the problem 
was how so conspicuous a being as the Elephant 
Man could be got there, and how he was to see 
the performance without attracting the notice of 
the audience and causing a panic or, at least, an 
unpleasant diversion. The whole matter was most 
ingeniously carried through by that kindest of 



The Elephant Man 31 

women and most able of actresses — Mrs. Kendal. 
She made the necessary arrangements with the 
lessee of the theatre. A box was obtained. 
Merrick was brought up in a carriage with drawn 
blinds and was allowed to make use of the royal 
entrance so as to reach the box by a private stair. 
I had begged three of the hospital sisters to don 
evening dress and to sit in the front row in order 
to " dress " the box, on the one hand, and to form 
a screen for Merrick on the other. Merrick and 
I occupied the back of the box which was 
kept in shadow. All went well, and no one 
saw a figure, more monstrous than any on 
the stage, mount the staircase or cross the 
corridor. 

One has often witnessed the unconstrained 
delight of a child at its first i)antomime, but 
Merrick's rapture was much more intense as well 
as much more solemn. Here was a being with the 
brain of a man, the fancies of a youth and the 
imagination of a child. His attitude was not so 
much that of delight as of wonder and amazement. 
He was awed. He was enthralled. The spectacle 
left him speechless, so that if he were spoken to 
he took no heed. He often seemed to be panting 
for breath. I could not help comparing him with 
a man of his own age in the stalls. This satiated 



32 The Elephant Man 

individual was bored to distraction, would look 
wearily at the stage from time to time and then 
yawn as if he had not slept for nights ; while at 
the same time Merrick was thrilled by a vision that 
was almost beyond his comprehension. Merrick 
talked of this pantomime for weeks and weeks. 
To him, as to a child with the faculty of make- 
believe, everything was real ; the palace was the 
home of kings, the princess was of royal blood, 
the fairies were as undoubted as the children in the 
street, while the dishes at the banquet were of 
unquestionable gold. lie did not like to discuss it 
as a play but rather as a vision of some actual 
world. When this mood possessed him he would 
say : "I wonder what the prince did after we 
left," or " Do you think that poor man is still 
in the dungeon? " and so on and so on. 

The splendour and display impressed him, but, 
I think, the ladies of the ballet took a still greater 
hold upon his fancy. He did not like the ogres 
and the giants, while the funny men impressed him 
as irreverent. Having no experience as a boy of 
romping and ragging, of practical jokes or of 
"larks," he had little sympathy with the doings 
of the clown, but, I think (moved by some mis- 
chievous instinct in his subconscious mind), he 
was pleased when the policeman was smacked in 



The Elephant Man 33 

the face, knocked down and generally rendered 
undignified. 

Later on another longing stirred the depths 
of Merrick's mind. It was a desire to see the 
country, a desire to live in some green secluded 
spot and there learn something about flowers and 
the ways of animals and birds. The country as 
viewed from a w^agon on a dusty high road was 
all the country he knew. He had never wandered 
among the fields nor followed the windings of a 
wood. He had never climbed to the brow of a 
breezy down. He had never gathered flowers in 
a meadow. Since so much of his reading dealt 
with country life he was possessed by the wish 
to see the wonders of that life himself. 

This involved a difficulty greater than that pre- 
sented by a visit to the theatre. The project was, 
however, made possible on this occasion also by 
the kindness and generosity of a lady — Lady 
Knightley — who offered Merrick a holiday home 
in a cottage on her estate. Merrick was conveyed 
to the railway station in the usual way, but as he 
could hardly venture to appear on the platform 
the railway authorities w^re good enough to run 
a second-class carriage into a distant siding. To 
this point Merrick was driven and was placed in 
the carriage unobserved. The carriage, with the 



34 The Elephant Man 

curtains drawn, was then attached to the main- 
Hne train. 

He duly arrived at the cottage, but the house- 
wife (hke the nurse at the hospital) had not been 
made clearly aware of the unfortunate man's 
appearance. Thus it happened that when Merrick 
presented himself his hostess, throwing her apron 
over her head, fled, gasping, to the fields. She 
affirmed that such a guest was beyond her powers 
of endurance, for, when she saw him, she was 
*' that took" as to be in danger of being per- 
manently '* all of a tremble." 

Merrick was then conveyed to a gamekeeper's 
cottage which was hidden from view and was close 
to the margin of a wood. The man and his wife 
were able to tolerate his presence. They treated 
him with the greatest kindness, and with them he 
spent the one supreme holiday of his life. He 
could roam where he pleased. He met no one on 
his wanderings, for the wood was preserved and 
denied to all but the gamekeeper and the forester. 

There is no doubt that Merrick passed in this 
retreat the happiest time he had as yet experienced. 
He was alone in a land of wonders. The breath 
of the country passed over him like a healing 
wind. Into the silence of the wood the fearsome 
voice of the showman could never penetrate. No 



The Elephant Man 35 

cruel eyes could peep at him through the friendly 
undergrowth. It seemed as if in this place of 
peace all stain had been wiped away from his 
sullied past. The Merrick who had once crouched 
terrified in the filthy shadows of a Mile End shop 
was now sitting in the sun, in a clearing among 
the trees, arranging a bunch of violets he had 
gathered. 

His letters to me were the letters of a delighted 
and enthusiastic child. He gave an account of his 
trivial adventures, of the amazing things he had 
seen, and of the beautiful sounds he had heard. 
He had met with strange birds, had startled a 
hare from her form, had made friends with a fierce 
dog, and had watched the trout darting in a stream. 
He sent me some of the wild flowers he had picked. 
They were of the commonest and most familiar 
kind, but they were evidently regarded by him 
as rare and precious specimens. 

He came back to London, to his quarters in 
Bedstead Square, much improved in health, pleased 
to be " home ' ' again and to be once more among 
his books, his treasures and his many friends. 

Some six months after Merrick's return from 
the country he was found dead in bed. This was 
in April, 1890. He was lying on his back as if 
asleep, and had evidently died suddenly and with- 



36 The Elephant Man 

out a struggle, since not even the coverlet of the 
bed was disturbed. The method of his death was 
peculiar. So large and so heavy was his head that 
he could not sleep lying down. When he assumed 
the recumbent position the massive skull was 
inclined to drop backwards, with the result that 
he experienced no little distress. The attitude he 
was compelled to assume when he slept was very 
strange. He sat up in bed with his back supported 
by pillows, his knees were drawn up, and his arms 
clasped round his legs, while his head rested on 
the points of his bent knees. 

He often said to me that he wished he could 
lie down to sleep "like other people." I think 
on this last night he must, with some determina- 
tion, have made the experiment. The pillow was 
soft, and the head, when placed on it, must have 
fallen backwards and caused a dislocation of the 
neck. Thus it came about that his death was due 
to the desire that had dominated his life — the 
pathetic but hopeless desire to be " like other 
people." 

As a specimen of humanity, Merrick was 
ignoble and repulsive ; but the spirit of Merrick, 
if it could be seen in the form of the living, would 
assume the figure of an upstanding and heroic man, 



The Elephant Man 37 

smooth browed and clean of limb, and with eyes 
that flashed undaunted courage. 

His tortured journey had come to an end. 
All the way he, like another, had borne on his 
back a burden almost too grievous to bear. He 
had been plunged into the Slough of Despond, 
but with manly steps had gained the farther shore. 
He had been made " a spectacle to all men " in 
the heartless streets of Vanity Fair. He had been 
ill-treated and reviled and bespattered with the 
mud of Disdain. He had escaped the clutches of 
the Giant Despair, and at last had reached the 
"Place of Deliverance," where "his burden 
loosed from off his shoulders and fell from off his 
back, so that he saw it no more.' 



jj 



THE OLD RECEIVING ROOM 



II 

THE OLD RECEIVING ROOM 

A HOUSE surgeon at a great accident 
hospital in the east of London happens 
upon strange scenes, some pathetic, some merely 
sordid, together with fragments of tragedy in 
which the most elemental passions and emotions 
of humanity are displayed. The chief place in 
w'hich this experience is gained is the Receiving 
Room. I speak of a hospital not as it is now, but 
as it was some fifty years ago. The Receiving 
Room is a bare hall, painted stone colour. It 
contains as furniture rows of deal benches and as 
wall decoration a printed notice, framed and 
glazed, detailing vivid measures for restoring the 
apparently drowned. Below this helpful document 
is fixed an iron-bound money-box. There is, 
moreover, a long desk in the hall where entries 
are made and certificates and other papers issued. 
As a room for the reception of the sick and 
suffering it is a cold, harsh place, with about it 
an air of cynical indifference. 

This hall serves as a waiting-room, and there 
D 41 



42 The Old Receiving Room 

are nearly always some people waiting in it. It 
may be a sniffing woman who has called for her 
dead husband's clothes. It may be a still breath- 
less messenger with a " midwifery card " in her 
hand, or a girl waiting for a dose of emergency 
medicine. There may be some minor accident 
cases also, such as a torn finger, a black eye like 
a bursting plum, a child who has swallowed a 
halfpenny, and a woman who has been " knocked 
about cruel," but has little to show for it except 
a noisy desire to have her husband "locked up." 
In certain days of stress, as on Saturday nights, 
when the air is heavy with alcohol, or on the 
occasion of a "big" dock accident, the waiting- 
room is crowded with excited folk, with patients 
waiting their turn to be dressed, with policemen, 
busybodies, reporters and friends of the injured. 

On each side of the waiting-hall is a dressing- 
room — one for women, one for men. Into these 
rooms the accident cases are taken one after the 
other. Here the house surgeon and his dressers 
are engaged, and here the many-sided drama of 
the Receiving Room reaches its culminating point. 
It is an uninviting room, very plain, and, like the 
outer hall, bears an 'aspect of callous unconcern. 
By the window is a suspiciously large sink, and on 
the ledge above it a number of pewter porringers. 



The Old Receiving Room 43 

One side of the room is occupied by a mysterious 
cupboard containing dressings, gags, manacles, 
emetics and other unattractive things. In the 
centre are a common table and two hard chairs. 

The most repellent thing in the room is a low 
sofa. It is wide and is covered with very thick 
leather which is suspiciously shiny and black. It 
suggests no more comfort than a rack. Its 
associations are unpleasant. It has been smothered 
with blood and with every kind of imaginable 
filth, and has been cleaned up so often that it is 
no wonder that the deeply stained leather is 
shiny. It is on this grim black couch that " the 
case " just carried into the hospital is placed. It 
may be a man ridden over in the street, with the 
red bone-ends of his broken legs sticking through 
his trousers. It may be a machine accident, where 
strips of cotton shirt have become tangled up 
with torn flesh and a trail of black grease. It 
may be a man picked up in a lane with his throat 
cut, or a woman, dripping foul mud, who has 
been dragged out of a river. Sometimes the 
occupant of the sofa is a snoring lump of humanity 
so drunk as to be nearly dead, or it may be a 
panting woman who has taken poison and 
regretted it. In both cases the stomach pump is 
used with nauseating incidents. Now and then 



44 The Old Receiving Room 

the sofa is occupied by a purple-faced maniac, who 
is pinned down by sturdy dressers while a strait- 
jacket is being applied to him. This is not the 
whole of its history nor of its services, for the 
Receiving Room nurse, who is rather proud of 
it, likes to record that many a man and many a 
woman have breathed their last on this horrible 
divan. 

The so-called dressing room is at its best a 
" messy " place, as two mops kept in the corner 
seem to suggest. It is also at times a noisy place, 
since the yells and screams that escape from it 
may be heard in the street and may cause passers- 
by to stop and look up at the window. 

Among the sick and the maimed who are 
** received " in this unsympathetic hall, the most 
pathetic are the wondering babies and the 
children. Many are brought in burnt and v/rapped 
up in blankets, with only their singed hair show- 
ing out of the bundle. Others have been scalded, 
so that tissue-paper-like sheets of skin come off 
when their dressings are applied. Not a few, in 
old days, were scalded in the throat from drinking 
out of kettles. Then there are the children who 
have swallowed things, and v/ho have added to the 
astounding collection of articles — from buttons to 
prayer-book clasps — which have found their way, 



The Old Receiving Room 45 

at one time or another, into the infant interior, 
as well as children who have needles embedded in 
parts of their bodies or have been bitten by dogs 
or cats or even by rats. 

I remember one bloated, half-dressed woman 
who ran screaming into the Receiving Room with 
a dead baby in her arms. She had gone to bed 
drunk, and had awakened in the morning in a 
tremulous state to find a dead infant by her side. 
This particular experience was not unusual in 
Whitechapel. Then there was another woman 
who rushed in drawing attention to a thing like a 
tiny bead of glass sticking to her baby's cheek. 
The child had acute inflammation of the eyeball, 
which the mother had treated with cold tea. The 
eye had long been closed, but when the mother 
made a clumsy attempt to open the swollen lids 
something had popped out, some fluid and this 
thing like glass. She was afraid to touch it. She 
viewed it with horror as a strange thing that had 
come out of the eye. Hugging the child, she had 
run a mile or so with the dread object still adher- 
ing to the skin of the cheek. This glistening 
thing was the crystalline lens. The globe had 
been burst, and the child was, of course, blind. 
Happily, such a case could hardly be met with at 
the present day. 



46 The Old Receiving Room 

On the subject of children and domestic 
surgery as revealed in the Receiving Room, I 
recall the case of a boy aged about four who had 
pushed a dry pea into his ear. The mother 
attempted to remove it with that common surgical 
implement of the home, a hairpin. She not only 
failed, but succeeded in pushing the pea farther 
down into the bony part of the canal. Being a 
determined woman, she borrowed a squirt, and 
proceeded to syringe out the foreign body with 
hot water. The result was that the pea swelled, 
and, being encased in bone, caused so intense and 
terrible a pain that the boy became unconscious 
from shock. 

Possibly the most dramatic spectacle in con- 
nexion with Receiving Room life in pre-ambulance 
days was the approach to the hospital gate of a 
party carrying a wounded woman or man. Look- 
ing out of the Receiving Room window on such 
occasion a silent crowd would be seen coming 
down the street. It is a closely packed crowd 
which moves like a clot, which occupies the whole 
pavement and oozes over into the road. In the 
centre of the mass is an obscure object towards 
which all eyes are directed. In the procession are 
many women, mostly with tousled heads, men, 
mostly without caps, a butcher, a barber's 



The Old Receiving Room 47 

assistant, a trim postman, a whitewasher, a man 
in a tall hat, and a pattering fringe of ragged 
boys. The boys, being small, cannot see much, 
so they race ahead in relays to glimpse the 
fascinating object from the front or climb up rail- 
ings or mount upon steps to get a view of it as it 
passes by. Possibly towering above the throng 
would be two pohcemen, presenting an air of 
assumed calm ; but policemen were not so common 
in those days as they are now. 

The object carried would be indistinct, being 
hidden from view as is the queen bee by a clump 
of fussing bees. Very often the injured person is 
merely carried along by hand, like a parcel that 
is coming to pieces. There would be a man to 
each leg and to each arm, while men on either 
side would hang on to the coat. Possibly some 
Samaritan, walking backwards, would hold up 
the dangling head. It was a much prized distinc- 
tion to clutch even a fragment of the sufferer or 
to carry his hat or the tools he had dropped. 

At this period the present-day stretcher was 
unknown in civil life. A stretcher provided by 
the docks was a huge structure with high sides. 
It was painted green, and was solid enough to 
carry a horse. A common means of conveyance 
for the helpless was a shutter, but with the 



48 The Old Receiving Room 

appearance of the modern ambulance the shutter 
has become as out of date as the sedan chair. 
Still, at this time, when anyone was knocked down 
in the street some bright, resourceful bystander 
would be sure to call out " Send for a shutter! " 

The conveying of a drunken man with a cut 
head to the hospital by the police (in the ancient 
fashion) was a more hilarious ceremonial. The 
" patient " would be hooked up on either side by 
an official arm. His body would sag between 
these two supports so that his shoulders would be 
above his ears. His clothes would be worked up 
in folds about his neck, and he would appear to 
be in danger of slipping earthwards out of them. 
As it was, there would be a display of shirt and 
braces very evident below his coat. His legs 
w^ould dangle below him like roots, while his feet, 
as they dragged along the pavement, would be 
twisted now in one direction and now in another 
like the feet of a badly stuffed lay figure. He 
would probably be singing as he passed along, to 
the delight of the people. 

Of the many Receiving Room processions that 
I have witnessed the most moving, the most 
savage and the most rich in colour, noise and 
language was on an occasion when two "ladies" 
who had been badly lacerated in a fight were being 



The Old Receiving Room 49 

dragged, carried or pushed towards the hospital 
for treatment. They were large, copious women 
who were both in an advanced stage of intoxica- 
tion. They had been fighting with gin bottles in 
some stagnant court which had become, for the 
moment, an uproarious cockpit. The technique 
of such a duel is punctilious. The round, smooth 
bottoms of the bottles are knocked off, and the 
combatants, grasping the weapons by the neck, 
proceed to jab one another in the face with the 
jagged circles of broken glass. 

The wounds in this instance were terrific. 
The faces of the two, hideously distorted, w^ere 
streaming with blood, while their ample bodies 
seemed to have been drenched with the same. 
Their hair, soaked in blood, was plastered to their 
heads like claret-coloured seaweed on a rock. The 
two heroines were borne along by their women 
friends. The police kept wisely in the background, 
for their time was not yet. The crowd around 
the two bleeding figures was so compressed that 
the whole mass moved as one. It was a wild 
crowd, a writhing knot of viragoes who roared 
and screamed and rent the air with curses and 
yells of vengeance, for they were partisans in the 
fight, the Montagues and Capulets of a ferocious 
feud. 



50 The Old Receiving Room 

The crowd as it came along rocked to and fro, 
heaved and kirched as if propelled by some uneasy 
sea. The very pavement seemed unsteady. Borne 
on the crest of this ill-smelling wave were the two 
horrible women. One still shrieked threats and 
defiance in a voice as husky as that of a beast, 
while now and then she lifted aloft a blood- 
streaked arm in the hand of which was clutched 
a tuft of hair torn from her opponent's head. 
Every display of this trophy called forth a shout 
of pride from her admirers. 

The other woman w^as in a state of drunken 
hysteria. Throwing back her head until the sun 
illumined her awful features, she gave vent to 
bursts of maniacal laughter which were made 
peculiarly hideous by the fact that her nose was 
nearly severed from her face, while her grinning 
lips were hacked in two. At another m.oment, 
burying her head against the back of the woman 
in front of her, she w^ould break out into sobs and 
groans which were even more unearthly than her 
laughter. 

The whole affair suggested some fearful 
Bacchanalian orgy, associated with bloodshed, in 
which all concerned were the subjects of demoniacal 
possession. There is, happily, much less drunken- 
ness nowadays and less savagery, while the police 



The Old Receiving Room 51 

control of these ' ' street scenes " is so efficient and 
the public ambulance so secretive that such a 
spectacle as I now recall belongs for ever to the 
past. 

When a crowd, bearing a '* casualty," reaches 
the hospital gates its progress is stayed. It rolls 
up against the iron barrier. It stops and recoils 
like a muddy wave against a bank. The porter 
is strict. Only the principals, their supporters 
and the police are allowed to filter through. The 
members of the crowd remain in the street, where 
they look through the raiUngs, to which they 
cling, and indulge in fragments of narrative, in 
comments on the affair, and on the prospects of 
the parties injured. If a scream should escape 
from the Receiving Room the watchers feel that 
they are well rewarded for long waiting, while 
any member of the privileged party who may 
leave the building is subjected to very earnest 
questioning. 

It is needless to say that the Receiving Room 
is not always tragical, not always the scene of 
alarms and disorders, not always filled with wild- 
eyed folk nor echoing the scuffle of heavy feet and 
the moans of the suffering. It may be as quiet 
as a room in a convent. I have seen it so many a 
time, and particularly on a Sunday morning in 



52 The Old Receiving Room 

the heyday of summer. Then the sun, streaming 
through the windows, may illumine the figure of 
the nurse as she sits on the awful sofa. She has 
her spectacles on, and is busy with some white 
needlework. Her attitude is so placid that she 
might be sitting at a cottage door listening to a 
blackbird in a wicker cage. Yet this quiet- 
looking woman, although she has not fought 
with wild beasts at Ephesus, has fought with 
raving drunkards and men delirious from their 
hurts, and has heard more foul language and 
more blasphemy in a week than would have 
enlivened a pirate ship in a year. 

The Receiving Room nurse was, in old days, 
without exception the most remarkable woman in 
the hospital. She appeared as a short, fat, com- 
fortable person of middle age, with a ruddy face 
and a decided look of assurance. She was without 
education, and yet her experience of casualties 
of all kinds — from a bee-sting to sudden death — 
was vast and indeed unique. She was entirely 
self-taught, for there were no trained nurses in 
those days. She was of the school of Mrs. Gamp, 
was a woman of courage and of infinite resource, 
an expert in the treatment of the violent and in 
the crushing of anyone who gave her what she 
called "lip." She was possessed of much humour. 



The Old Receiving Room 53 

was coarse in her language, abrupt, yet not un- 
kindly in her manner, very indulgent towards the 
drunkard and very skilled in handling him. She 
was apt to boast that there was no man living she 
would not " stand up to." She called every male 
over fifty "Daddy" and every one under that 
age " My Son." She would tackle a shrieking 
woman as a terrier tackles a rat, while the woman 
who " sauced " her she soon reduced to a condition 
of palsy. She objected to the display of emotion 
or of feeling in any form, and was apt to speak 
of members of her sex as a " watery-headed lot." 
She had, like most nurses of her time, a lean- 
ing towards gin, but was efficient even in her cups. 
She had wide powers, for she undertook — on her 
own responsibility — the treatment of petty casual- 
ties. The dressers regarded her with respect. Her 
knowledge and skill amazed them, while from her 
they acquired the elements of minor surgery and 
first aid. The house surgeons were a little 
frightened of her, yet they admired her ready 
craft and were duly grateful for her unswerving 
loyalty and her eagerness to save them trouble. 
Her diagnosis of an injury was probably correct, 
so sound was her observation and wide her experi- 
ence. She was a brilliant bandager, and was 
accepted by the students as the standard of style 



54 The Old Receiving Room 

and finish in the applying of a dressing. She was 
on duty from early in the morning until late at 
night, and knew little of " hours off " and " half- 
days." In the personnel of the hospital of half 
a century ago she was an outstanding figure, yet 
now she is as extinct as the dodo. 

The hospital in the days of which I speak was 
anathema. The poor people hated it. They 
dreaded it. They looked upon it primarily as a 
place where people died. It ^vas a matter of 
difficulty to induce a patient to enter the wards. 
They feared an operation, and with good cause, 
for an operation then was a very dubious matter. 
There were stories afloat of things that happened 
in the hospital, and it could not be gainsaid that 
certain of those stories were true. 

Treatment was very rough. The surgeon was 
rough. He had inherited that attitude from the 
days when operations were carried through with- 
out anaesthetics, and when he had need to be 
rough, strong and quick, as well as very indifferent 
to pain. Pain was with him a thing that had to 
be. It was a regrettable feature of disease. It 
had to be submitted to. At the present day pain 
is a thing that has not to be. It has to be relieved 
and not to be merely endured. 

Many common measures of treatment involved 



The Old Receiving Room 55 

great suffering. Bleeding was still a frequent 
procedure, and to the timid the sight of the red 
stream trickling into the bowl was a spectacle of 
terror. There were two still more common 
measures in use — the seton and the issue. The 
modern student knows nothing of these ancient 
and uncleanly practices. He must inform him- 
self by consulting a dictionary. Without touching 
upon details, I may say that in my early days, as 
a junior dresser, one special duty was to run round 
the ward before the surgeon ai*rived in order to 
draw a fresh strand of thread through each seton 
and to see that a fresh pea was forced into the 
slough of every issue. 

Quite mediaeval methods were still observed. 
The first time in my life that I saw the interior 
of an operating theatre I, in my ignorance, 
entered by the door which opened directly into 
the area where the operating table stood. (I 
should have entered by the students' gallery.) 
When I found myself in this amazing place 
there was a man on the table who was shrieking 
vehemently. The surgeon, taking me by the arm, 
said, " You seem to have a strong back ; lay hold 
of that rope and pull." I laid hold of the rope. 
There were already two men in front of me and 
we all three pulled our best. I had no idea what 



56 The Old Receiving Room 

we were pulling for. I was afterwards informed 
that the operation in progress was the reduction 
of a dislocated hip by compound pulleys. The 
hip, however, was not reduced and the man 
remained lame for life. At the present day a 
well-instructed schoolgirl could reduce a recent 
hip dislocation unaided. 

In this theatre was a stove which was always 
kept alight, winter and summer, night and day. 
The object was to have a iEire at all times ready 
whereat to heat the irons used for the arrest of 
bleeding as had been the practice since the days 
of Elizabeth. Antiseptics were not yet in use. 
Sepsis was the prevailing condition in the wards. 
Practically all major wounds suppurated. Pus 
was the most common subject of converse, because 
it was the most prominent feature in the surgeon's 
work. It was classified according to degrees ol: 
vileness. " Laudable" pus was considered rather 
a [fine thing, something to be proud of. 
" Sanious " pus was not only nasty in appearance 
but regrettable, while "ichorous" pus repre- 
sented the most malignant depths to which matter 
could attain. 

There was no object in being clean. Indeed, 
cleanliness was out of place. It was considered 
to be finicking and affected. An executioner 



The Old Receiving Room 57 

might as well manicure his nails before chopping 
off a head. The surgeon operated in a slaughter- 
house-suggesting frock coat of black cloth. It 
was stiff with the blood and the filth of years. 
The more sodden it was the more forcibly did it 
bear evidence to the surgeon's prowess. I, of 
course, commenced my surgical career in such a 
coat, of which I was quite proud. Wounds were 
dressed with " charpie " soaked in oil. Both oil 
and dressing were frankly and e^cultingly septic. 
Charpie was a species of cotton waste obtained 
from cast linen. It would probably now be dis- 
carded by a motor mechanic as being too dirty 
for use on a car. 

Owing to the suppurating wounds the stench 
in the wards was of a kind not easily forgotten. 
I can recall it to this day with unappreciated ease. 
There was one sponge to a ward. With this putrid 
article and a basin of once-clear water all the 
wounds in the ward were washed in turn twice a 
day. By this ritual any chance that a patient 
had of recovery was eliminated. I remember a 
whole ward being decimated by hospital gangrene. 
The modern student has no knowledge of this 
disease. He has never seen it and, thank heaven, 
he never will. People often say how wonderful 
it was that surgical patients lived in these days. 



58 The Old Receiving Room 

As a matter of fact they did not live, or at least 
only a few of them. Lord Roberts assured me 
that on the Ridge at Delhi during the Indian 
Mutiny no case of amputation recovered. This is 
an extreme instance, for the conditions under 
which the surgeons on the Ridge operated were 
exceptional and hopelessly unfavourable. 

The attitude that the public assumed towards 
hospitals and their works at the time of which I 
write may be illustrated by the following incident. 
I w^as instructed by my surgeon to obtain a 
woman's permission for an operation on her 
daughter. The operation was one of no great 
magnitude. I interviewed the mother in the 
Receiving Room. I discussed the procedure with 
her in great detail and, I trust, in a sympathetic 
and hopeful manner. After I had finished my 
discourse I asked her if she would consent to the 
performance of the operation. She replied : " Oh ! 
it is all very well to talk about consenting, but 
who is to pay for the funeral.^ 



>? 



THE TWENTY-KRONE PIECE 



Ill 

THE TWENTY-KRONE PIECE 

MORE than once in speaking at public 
meetings on behalf of hospitals I have 
alluded to my much valued possession — a 
twenty-krone piece — and have employed it as 
an illustration of the gratitude of the hospital 
patient. 

The subject of this incident was a Norwegian 
sailor about fifty years of age, a tall, good-featured 
man with the blue eyes of his country and a face 
tanned by sun and by salt winds to the colour of 
weathered oak. His hair and his beard were grey, 
which made him look older than he was. He 
had been serving for three years as an ordinary 
seaman on an English sailing ship and spoke 
English perfectly. During his last voyage he had 
developed a trouble which prevented him from 
following his employment. Accordingly he had 
left his ship and made his way to London in the 
hope of being cured. Inquiring for the hospital 
of London he was directed to the London Hos- 
pital and, by chance, came into my wards. He 

6i 



62 The Twenty-Krone Piece 

had an idea — as I was told later — that the opera- 
tion he must needs undergo might be fatal, and 
so had transferred his savings to his wife in Norway. 

He was a quiet and reserved man, but so 
pleasant in his manner that he became a favourite 
with the nurses. He told them quaintly-worded 
tales of his adventures and showed them how to 
make strange knots with bandages. The operation 
— which was a very ordinary one — was successful, 
and in four or five weeks he was discharged as 
capable of resuming his work as a seaman. His 
ship had, however, long since started on another 
voyage. 

One morning, three weeks after he had left 
the hospital, he appeared at my house in Wimpole 
Street. My name he would have acquired from the 
board above his bed, but I wondered how he had 
obtained my address. I assumed that he had 
called to ask for money or for help of some kind. 
As he came into my room I was sorry to see how 
thin and ill he looked, for when he left the wards 
he was well and hearty. 

He proceeded to thank me for what I had done, 
little as it was. He had an exaggerated idea of 
the magnitude of the operation, which idea he 
would not allow me to correct. I have listened 
to many votes of thanks, to the effulgent language, 



The Twenty-Krone Piece 63 

the gush and the pompous flattery which have 
marked them ; but the Httle speech of this sailor 
man was not of that kind. It was eloquent by 
reason of its boyish simplicity, its warmth and 
its rugged earnestness. 

As he was speaking he drew from his pocket 
a gold coin, a twenty-krone piece, and placed it 
on the table at which I sat. " I beg you, sir," 
he said, " to accept this coin. I know it is of no 
yalue to you. It is only worth, I think, fifteen 
shillings. It would be an insult to offer it as a 
return for what you have done for me. That 
service can never be repaid. But I hope you will 
accept it as a token of what I feel, of something 
that I cannot say in words but that this coin can 
tell of. When I left my home in Norway three 
years ago my wife sewed this twenty-krone piece 
in the band of my trousers and made me promise 
never to touch it until I was starving. A seaman's 
life is uncertain; he may be ill, he may be long 
out of a job ; and so for three years this coin has 
been between me and the risk of starvation. When 
I was in the hospital I had a wish to give it to 
you if it so happened that I got well. Here I 
am, and I do hope, sir, you will accept it." 

I thanked him as warmly as I could for his 
kindness, for his thought in coming to see me and 



64 The Twenty-Krone Piece 

for his touching offer, but added that I could not 
possibly take the gold piece and begged him to 
put it back into his pocket again and present it 
to his wife when he reached home. At this he 
was very much upset. Pushing the coin along 
the table towards me with his forefinger, he said : 
" Please, sir, do take the money, not for what it 
is .worth but for what it has been to me. I am 
proud to say that since I left the hospital I have 
been starving. I have been looking for a ship. 
I have not slept in a bed since you saw me in the 
wards. Now, at last, I have got a ship and, thank 
God, I have kept the coin unbroken so that you 
might have it. I implore you to accept it." 

I took it ; but what could I say that would 
be adequate for such a gift as this? My attempt 
at thanks was as stumbling and as feeble as his 
had been outright ; for I am not ashamed to con- 
fess that I was much upset. 

I have received many presents from kindly 
patients — silver bowls, diamond scarf-pins, gold 
cigarette cases and the like, but how little is their 
value compared with this one small coin? As I 
picked it up from the table I thought of what 
it had cost. I thought of the tired man haunting 
the docks in search of a ship, often aching with 
hunger and at night sleeping in a shed, and yet 



The Twenty-Krone Piece 65 

all the time .with a piece of gold in his pocket 
which he >vould not change in order that I might 
have it. 

A coin is an emblem of wealth, but this gold 
piece is an emblem of a rarer currency, of that 
wealth which is — in a peculiar sense — ' ' beyond 
the dream of avarice," a something that no money 
could buy, for what sum could express the bounty 
or the sentiment of this generous heart? 

It would be described, by those ignorant of its 
history, as a gold coin from Norway ; but I prefer 
to think that it belongs to that " land of Havilah 
where there is gold ' ' and of which it is truly said 
" and the gold of that land is good." 



A CURE FOR NERVES 



IV 

A CURE FOR NERVES 

IN the account of the case which follows it is 
better that I allow the patient to speak for 
herself. 

I am a neurotic woman. In that capacity I 
have been the subject of much criticism and much 
counsel. I have been both talked to and talked 
at. On the other hand I have detailed my unhappy 
isymptoms to many in the hope of securing con- 
solation, but with indefinite success. I am afraid 
I have often been a bore ; for a bore, I am told, 
is a person who will talk of herself when you want 
to talk of yourself. 

My husband says that there is nothing the 

matter with me, that my ailments are all imaginary 

and unreasonable. He becomes very cross when 

I talk of my wretched state and considers my 

ill-health as a grievance personal to himself. He 

says — when he is very irritated — that he is sick 

of my moanings, that I look well, eat well, sleep 

well, and so must be as sound as a woman can 

be. If I have a headache and cannot go out he 

69 



70 A Cure for Nerves 

is more annoyed than if he had the headache 
himself, which seems to me irrational. He is 
often very sarcastic about my symptoms, and this 
makes me worse. Once or twice he has been 
sympathetic and I have felt better, but he says 
that sympathy will do me harm and cause me to 
give way more. I suppose he knows because he 
is always so certain. He says all I have to do is 
to cheer up, to rouse myself, to pull myself 
together. He slaps himself on the chest and, in 
a voice that makes my head crack, says, " Look 
at me ! I am not nervous, why should you be? " 
I don't know why I am nervous and so I never 
try to answer the question. From the way my 
husband talks I feel that he must regard me as an 
impostor. If we have a few friends to dinner he 
is sure to say something about "the deplorable 
flabbiness of the minds of some women." I know 
he is addressing himself to me and so do the others, 
but I can only smile and feel uncomfortable. 

I have no wish to be nervous. It is miserable 
enough, heaven knows. I would give worlds to 
be free of all my miseries and be quite sound 
again. If I wished to adopt a complaint I 
should choose one less hideously distressing than 
"nerves." I have often thought I would sooner 
be blind than nervous, and that then my husband 



A Cure for Nerves 71 

(Would be really sorry for me ; but I should be 
terribly frightened to be always in the dark. 

I get a good deal of comfort from many of my 
women friends. They at least are sympathetic ; 
they believe in me, know that my complaints are 
real and that what I say is true. Unfortunately, 
when I have described certain of my symptoms — 
guch as one of my gasping attacks — they say that 
they have just such attacks themselves, only worse. 
They are so sorry for me ; but then they will go 
on and tell me the exact circumstances under 
which they have had their last bouts. I am 
anxious to tell them of my other curious symp- 
toms, but they say that it does them so much good 
to pour out their hearts to someone, and I, being 
very meek, let them go on, only wishing that 
they would listen to me as I listen to them. 

I notice that their husbands have for the most 
part just the same erroneous views about nerves 
that mine has. Some of them say that they would 
like to make their menfolk suffer as they do them- 
selves. One lady I know always ends with the 
reflection : " Ah, well ! I shall not be long here, 
and when I am dead and under the daisies he will 
be sorry he was not more appreciative. He will 
then know, when it is too late, that my symptoms 
were genuine enough." I must say that I have 



72 A Cure for Nerves 

never gone to the extreme of wishing to die 
for the mere sake of convincing my husband of 
obstinate stupidity. I should Hke to go into a 
death-hke trance and frighten him, for then I 
should be able to hear what he said when he thought 
I was gone and remind him of it afterwards w^hen- 
ever he became cynical. 

It is in the morning that I feel so bad. I 
am really ghastly then. I wake up with the awful 
presentiment that something dreadful is going to 
happen. I don't know what it is, yet I feel I 
could sink through the bed. I imagine the waking 
moments of the poor wretch who has been con- 
demned to death and who is said to have " slept 
well " on the night before his execution. He will 
probably awake slowly and will feel at first hazily 
happy and content, will yawn and smile, until 
there creeps up the horrible recollection of the 
judge and the sentence, of the gallows and the 
hanging by the neck. I know the cold sweat that 
breaks over the whole body and the sickly clutch- 
ing about the heart that attend such an awakening, 
but doubt if any emerging from sleep can be really 
worse than many I have experienced. 

I can do so little in the day-time. I soon get 
exhausted and so utterly done up that I can only 
lie still in a dark room. When I am like that the 



A Cure for Nerves 73 

least noise worries me and even tortures me almost 
out of my mind. If someone starts strumming 
the piano, or if a servant persistently walks about 
with creaky boots, or if my husband bursts in and 
tries to be hearty, I feel compelled to scream, it 
is so unbearable. 

It is on such an occasion as this that my husband 
is apt to beg me " to pull myself together." He 
quite maddens me when he says this. I feel as 
full of terror, awfulness and distress as a drowning 
man, and how silly it would be to lean over a 
harbour wall and tell a drowning man in comfort- 
able tones that he should " pull himself together." 
Yet that is what my husband says to me, with 
the irritating conviction that he is being intelligent 
and practical. 

I cannot walk out alone. If I attempt it I 
am soon panic-stricken. I become hot all over, 
very faint, and so giddy that I reel and have to 
keep to the railings of the houses. I am seized 
with the hideous feeling that I can neither get 
on nor get back. I am not disturbed by the mere 
possibility of falling down on the pavement, but 
by the paralysing nightmare that I cannot take 
another step. 

If anyone were to put me down in the middle 
of a great square, like the Pra9o de Dom Pedro 



74 A Cure for Nerves 

at Lisbon, and leave me there alone, I think I 
should die or lose my reason. I know I should be 
unable to get out. I should fall in a heap, shut 
my eyes and try to crawl to the edge on my hands 
and knees, filled all the time with a panting terror. 
A man who finds himself compelled to cross a 
glassy ice slope which, twenty feet below, drops 
over a precipice, could not feel worse than I do 
if left adrift, nor pray more fervently to be clear 
of the abhorred space and safe. My husband says 
that this is all nonsense. I suppose it is, but it 
is such nonsense as would be sense if the jester 
were Death. 

The knowledge that I have to go to a dinner 
party fills me with unutterable alarm. By the 
time I am dressed and ready to start I am chilled, 
shaking all over and gasping for breath. The 
drive to the house is almost as full of horror as 
the drive of the tumbril to the guillotine. By the 
time I arrive I am so ill I can hardly speak and 
am convinced that I shall fall down, or be sick, 
or shall have to cry out. More than once I have 
insisted upon being driven home again, and my 
husband has gone to the dinner alone after much 
outpouring of language. 

Possibly my most direful experiments have 
been at the theatre, to which I have been taken on 



A Cure for Nerves 75 

the ground that my mind needed change and that 
a cheerful play would " take me out of myself." 
My worst terrors have come upon me when I 
have chanced to sit in the centre of the stalls with 
people packed in all around me. I have then felt 
as if I was imprisoned and have been filled by one 
intense overwhelming desire — the passion to get 
■out. I have passed through all the horrors of 
suffocation, have felt that I must stand up, must' 
lift up my arms and gasp. I have looked at the 
door only to feel that escape was as impossible as 
it would be to an entrapped miner about whom 
the walls of a shaft had fallen. 

It is useless for my husband to nudge me and 
tell me not to make a fool of myself. If I did 
want to make a fool of myself I should select 
some more agreeable way of doing it. It is useless, 
moreover, to argue. No argument can dispel the 
ever-present sense of panic, of being buried alive, 
or relieve the hopeless feeling of inability to escape. 
I have sat out a play undergoing tortures beyond 
expression, until I have become collapsed and 
until my lip had been almost bitten through in 
the effort not to scream. No one would believe 
that I — a healthy-looking woman in a new Paris 
dress, sitting among a company of smiling folk 
— could be enduring as much agony as if I were 



76 A Cure for Nerves 

lodged in an iron cell the walls of which were 
gradually closing in around me. 

I am very fond of my clothes when I am well, 
but there are certain frocks 1 have come to loathe 
because they recall times when I have nearly 
gasped out my life in them. 

I have taken much medicine but with no 
apparent good. I envy the woman who believes 
in her nerve tonic, since such faith must be a 
great comfort to her. I knew a poor girl who 
became for a time a mental wreck, owing to her 
engagement having been broken off. She refused 
food and lived for a week — so she told me — ^on 
her mother's nerve tonic. She declared that it 
saved her reason. I tried it, but it only brought 
me out in spots. I have seen a good many doctors, 
but although they are all very kind, they seem 
to be dense and to have but the one idea of 
treating the neurotic woman as they would treat 
a frightened child or a lost dog. 

I was taken to one doctor because he had the 
reputation of being very sensible and outspoken. 
My husband said there was no nonsense about him. 
He certainly made no effort to be entertaining. 
After he had examined me he said that all my 
organs were perfectly sound. He then began to 
address me as " My dear lady," and at once I 



A Cure for Nerves 77 

knew what was coming. It was to tell me that 
I wanted rousing and that all I had to do was 
to get out of myself. He said I was not to think 
about myself at all, which is very good advice to 
a person who feels on the point of dissolution. 
He told my husband afterwards, in strict con- 
fidence, that if I was a poor woman and had to 
work for my living I should be well directly. He 
went farther and said that what would cure me 
would be a week at the washing tub — at a laundry, 
I suppose. My husband imparted these confidences 
to me as we drove home from the doctor's and 
said what a shrewd, common-sense man he was. 
My husband quite Hked him. 

Another doctor I went to was very sympathetic. 
He patted my hand and was so kind that he 
almost made me cry. He said he understood how 
real and intense my sufferings were. He knew 
I must have gone through tortures. He gave me 
a great many particulars as to how I was to live 
and said I was never to do anything I did not 
like. I wanted to come and see him again, but 
he insisted that I must go abroad at once to break 
with my sad associations and afford my shattered 
nerves a complete rest. He gave me a letter to 
a doctor abroad which he said contained a very 
full and particular account of my case. 



78 A Cure for Nerves 

Something happened to prevent me from leav- 
ing England, but six months later I came across 
the letter and, feeling it was no longer of use, 
opened it. It began, '* My dear Harry," and 
contained a great deal about their respective 
handicaps at golf and their plans for the summer. 
The kind doctor ended in this wise in a postscript : 

"The lady who brings this is Mrs. . She 

is a terrible woman, a deplorable neurotic. I need 
say no more about her, but I hope you won't mind 
my burdening you with her, for she is the kind 
of tedious person who bores me to death. How- 
ever she pays her fees." My husband sent the 
letter back to the doctor who wrote it, because he 
thought the memoranda about the golf handicaps 
would be interesting for him to keep. 

As I made no progress and as my friends were 
getting as tired of me as I was of myself, it was 
resolved that I should be taken " seriously in 
hand." I was therefore sent to a nursing home to 
undergo the rest cure. I had to lie in bed, be 
stuffed with food and be massaged daily. I was 
cut off from all communion with the familiar world 
and was allowed to receive neither letters nor 
newspapers. 

The idea underlying this measure is, I think, 
a little silly. It is in the main an attempt to cure 



A Cure for Nerves 79 

a patient by enforced boredom. The inducement 
offered is crudely this : ' ' You can go home as 
soon as you think fit to be well." I did not mind 
the quiet nor the lying in bed. The excessive 
feeding merely made me uncomfortable. The 
massage was a form of torture that I viewed with 
great loathing. The absence of news from home 
kept me in a state of unrest and apprehension. 
It was the continued speculation as to what was 
going on in my household which prevented me 
from sleeping at night. 

The withdrawal of all newspapers was evidently 
a punishment devised by a man. It was no punish- 
ment to me nor w^ould it be to the average w^oman. 
The nurse, of course, kept me informed of current 
events as she was extremely fond of talking and 
thereby rendered a newspaper unnecessary. She 
told me of the occasions when my husband called 
to inquire and always said that he looked very well 
and remarkably cheerful. She walked past my 
house once and came back with the information 
that the drawing-room blinds w^re up and that 
the sun was streaming into the room. This worried 
me a great deal as I don't like faded carpets and 
silks and am very fond of my furniture. 

After I had been in the home a few days I 
discovered that the institution was not wholly 



8o A Cure for Nerves 

devoted to rest-cure cases, but that it was also a 
surgical home where many operations were per- 
formed. This frightened me terribly because I 
began to wonder whether an operation had been 
an item of the programme when I was taken 
seriously in hand. I arrived at the conclusion that 
I was being " prepared for operation," that I was 
being "built up," with the result that I was 
prostrated by alarm. I felt that at any moment 
a man with a black bag might enter the room and 
proceed to chloroform me. There came upon me 
a conviction that I was being imprisoned, that I 
had been duped and trapped. Above all was the 
awful feeling, which nearly suffocated me, that I 
was powerless to escape. I thought my husband 
had been most base to desert me like this and 
hand me over, as it were, to unknown executioners. 
I have a dread of operations which is beyond 
expression. The mere thinking of the process of 
being chloroformed makes me sick and faint. You 
are held down on a table, I believe, and then 
deliberately suffocated. It must be as if a man 
knelt upon your chest and strangled you by grip- 
ping your throat with his hands. When I was 
a small girl I saw a cook dispose of a live mouse 
by sinking the mouse-trap in which it was im- 
prisoned in a bucket of water. I remember that 



A Cure for Nerves 8i 

the struggles of the mouse, as seen under water, 
were horrible to witness. When I grew up and 
was told about people being chloroformed for 
operation I always imagined that their feelings 
would be as hideous as those of the drowning 
mouse in a trap. 

I told all my suspicions and alarms to the nurse, 
who laughed at me contemptuously. She said : 
"You are merely a nerve case." ("Merely," 
thought I.) " No surgeon ever thinks of operating 
on a nerve case. The greater number of the 
patients here come for very serious operations. 
They are real patients." As she conversed further 
I must confess that my pride began to be touched. 
I had supposed that my case was the most im- 
portant and most interesting in the establishment. 
I had the largest room in the house while the 
fussing over me had been considerable. I now 
began to learn that there were others who were 
in worse plight than myself. I, on the one hand, 
had merely to lie in bed and sleep. They, on the 
other, came to the home ,with their lives in their 
hands to confront an appalling ordeal. I was 
haunted by indefinite alarms ; they had to submit 
to the tangible steel of the surgeon's knife. I 
began to be a little ashamed of myself and of the 
trouble I had occasioned. Compared with me 



82 A Cure for Nerves 

these women were heroines. They had something 
to fuss about, for they had to walk alone into the 
Valley of the Shadow of Death. I had many times 
said that I wished I was dead, but a little reflec- 
tion on the modes of dying made me keep that 
wish ever after unexpressed. 

My nurse deplored that she was not a surgical 
nurse. " To nurse an operation case is real 
nursing," she said. " There is something satis- 
factory in work like that. I am only a mental 
nurse, you see " — a confession which humbled me 
still further. 

It was in September that I entered the home, 
and as the leading surgeons were still out of 
London there were no operations. When October 
came the gruesome work was resumed. The 
house was set vibrating with excitement. In 
this I shared as soon as I discovered that the 
operating theatre was immediately over my bed- 
room. Almost the first operation happened to 
be a particularly momentous one, concerned with 
which was none other than the great surgeon of 
the day. His coming was anticipated with a buzz 
of interest by the nurses, an interest which was 
even shared by the mental nurse in whose charge 
I .was. 

I could learn very little about this great case 



A Cure for Nerves 83 

save that it was desperate and the victim a woman. 
I know that she entered the home the night before, 
for my nurse planned to meet her on her way to 
her room. I know also that just before the hour 
of closing the house I heard sobbing on the stair- 
case as two people slowly made their way down. 
I came to know afterwards that one was the hus- 
band, the other the daughter. 

The operation was to be at nine in the morn- 
ing. By 6 A.M. the whole house was astir. There 
was much running up and down stairs. Every- 
body was occupied. My morning toilet and 
breakfast were hurried through with little cere- 
mony. The nurse was excited, absent-minded 
and disinclined to answer questions. After my 
breakfast was cleared away she vanished — it 
was supposed that I was never to be left alone 
— and did not appear again until noon. When 
she did come back she found me an altered woman. 

I lay in bed in the soHtary room with my eyes 
fixed upon the white ceiling over my head. I was 
terrified beyond all reason. There was everywhere 
the sense of an overstrung activity, hushed and 
ominous, which was leading on to tragedy. I 
knew that in the room above me was about to be 
enacted a drama in which one of the actors was 
Death. 



84 A Cure for Nerves 

There was considerable bustle in the room in 
question. They were moving something very 
heavy into the middle of the floor. It was, I am 
sure, the operation table. Other tables were 
dragged about and adjusted with precision. Above 
the ceaseless patter of feet I could hear the pour- 
ing of water into basins. 

I knew when the surgeon and his assistants 
arrived, for I heard his voice on the stair. It 
was clear and unconcerned, the one strong and 
confident thing among all these portentous pre- 
parations. Heavy bags were carried up from the 
hall to be deposited on the floor above. I could 
hear the surgeon's firm foot overhead and noticed 
a further moving of tables. There came now a 
clatter of steel in metal dishes which made me 
shiver. 

I looked at the clock on my table. It was 
three minutes to nine. 

What of the poor soul who was waiting ? She 
also would be looking at the clock. Three minutes 
more and she would be led in her nightdress into 
this chamber of horrors. The very idea paralysed 
tme. If I were in her place I should scream until 
I roused the street. I should struggle with every 
fibre of my body. I should cling to the door 
until my arms were pulled out of their sockets. 



A Cure for Nerves 85 

A barrel-organ in the road was playing a trivial 
waltz, a boy was going by whistling, the world 
was cheerfully indifferent, while the loneliness of 
the stricken woman was horrible beyond words. 

As the church clock struck nine I knew that 
the patient was entering the room. I fancied I 
could hear the shuffle of her slippers and the 
closing of the door — the last hope of escape — 
behind her. A chair was moved into position. 
She was stepping on to the table. 

Then came an absolute silence. I knew they 
were chloroforming her. I fancied that the vapour 
of that sickly drug was oozing through the ceiling 
into my room. I was suffocated. I gasped until 
I thought my chest would burst. The silence was 
awful. I dared not scream. I would have rung 
my bell but the thought of the noise it would 
make held me back. 

I lay glaring at the ceiling, my forehead 
covered with drops of cold sweat. I wrung my 
fingers together lest all sensation should go out 
of them. 

In a while there came three awful moans from 
the room above and then once more the moving, 
of feet was to be heard, whereby I felt that the 
operation had begun. I could picture the knife, 
the great cut, the cold callousness of it all. For 



86 A Cure for Nerves 

.what seemed to me to be interminable hours I 
gazed at the ceihng. How long was this murder- 
ing to go on ! How could the poor moaning 
soul be tortured all this while and endure another 
minute ! 

Suddenly there was a great commotion in the 
room above. The table was dragged round rapidty. 
There were footsteps everywhere. Was the opera- 
tion over? No. Something had gone wrong. A 
man dashed downstairs calling for a cab. In a 
moment I could hear the wheels tear along the 
street and then return. He had gone to fetch 
something and rushed upstairs with it. 

This made me wonder for a moment what had 
happened to the husband and daughter who were 
waiting in a room off the hall. Had they died 
of the suspense? Why did they not burst into 
the room and drag her away while there was yet 
time? The lower part of the house was practic- 
ally empty and I was conscious that two or three 
times the trembling couple had crept up the stairs 
to the level of my room to listen. I could hear 
the daughter say, "What shall we do! What 
shall we do ! " And then the two would stumble 
down the stairs again to the empty room. 

I still glared at the ceiling like one in a trance. 
I had forgotten about myself, although there was 



A Cure for Nerves 87 

such a sinking at my heart that I could only 
breathe in gasps. The loathsome bustle in the 
room above continued. 

Now, as I gazed upwards, I noticed to my 
expressionless horror a small round patch of red 
appear on the white ceiling. I knew it was blood. 
The spot was as large as a five-shilling piece. It 
grew until it had become the size of a plate. 

It burnt into my vision as if it had been a 
red-hot disk. It became a deeper crimson until 
at last one awful drop fell upon the white coverlet 
of my bed. It came down with the weight of 
lead. The impact went through me like an 
electric shock. I could hardly breathe. I was 
bathed with perspiration and was as wet and as 
cold as if I had been dragged out of a winter's 
river. 

Another drop fell with a thud like a stone. I 
would have hidden my head under the bedclothes 
but I dared not stir. As each drop fell on the 
bed the interval came quicker until there was a 
scarlet patch on the white quilt that grew and grew 
and grew. I felt that the evil stain would come 
through the coverings, hot and wet, to my clenched 
hands which were just beneath, but I was unable 
to move them. My sight was now almost gone. 
There was nothing but a red haze filling the room. 



88 A Cure for Nerves 

a beating sound in my ears and the drop recurring 
like the ticking of some awful clock. 

I must have become unconscious for I cannot 
remember the nurse entering the room. When I 
realized once more where I was I found that the 
bedclothes had been changed. There was still the 
round red mark on the ceiling but it was now dry. 

As soon as I could speak I asked, " Is she 
dead? " The nurse answered "No." '' Will she 
live? " " Yes, I hope she will, but it has been 
a fearful business. The operation lasted two and 
a quarter hours, and when the great blood vessel 
gave way they thought it was all over." "Was 
she frightened? " I asked. " No ; she walked into 
the room, erect and smiling, and said in a jesting 
voice, ' I hope I have not kept you waiting, 
gentlemen, as I know you cannot begin without 
me.' " 

In a week I returned home cured. My 
" nerves" were gone. It was absurd to say that 
I could not walk in the street when that brave 
woman had walked, smiling, into that place of 
gags and steel. When I thought of the trouble I 
had made about going to the play I recalled what 
had passed in that upper room. I began to 
think less of my " case " when I thought of hers. 

The doctor was extremely pleased with my 



A Cure for Nerves 89 

recovery ; while his belief in the efficacy of the rest 
cure became unbounded. I did not trouble to tell 
him that I owed my recovery not to his tiresome 
physic and ridiculous massage but to that red 
patch on the ceiling. 

The lady of the upper room got well. Through 
the instrumentality of the nurse I was able to 
catch sight of her when she was taking her first 
walk abroad after the operation. I expected to 
see a goddess. I saw only a plain little woman 
with gentle eyes and a very white face. I knew 
that those eyes had peered into eternity. 

Some years have now passed by, but still when- 
ever I falter the recollection of that face makes 
me strong. 



TWO WOMEN 



y 

TWO WOMEN 

IN the course of his experience the medical man 
acquires probably a more intimate knowledge 
of human nature than is attained by most. He 
gains an undistorted insight into character. He 
witnesses the display of elemental passions and 
emotions. He sees his subject, as it were, un- 
clothed and in the state of a primitive being. 
There is no camouflage of feeling, no assumption 
of a part, no finesse. There is merely a man or 
a woman faced by simple, rudimentary conditions. 
He notes how they act under strain and stress, 
under the threat of danger or when menaced by 
death. He observes their behaviour both during 
suffering and after relief from pain, the manner 
in which they bear losses and alarms and how they 
express the consciousness of joy. These are the 
common emotional experiences of life, common 
alike to the caveman and the man of the twentieth 
century. Among the matters of interest in this 
purview is the comparative bearing of men and of 
women when subject to the hand of the surgeon. 

93 



94 Two Women 

As to which of the two makes the better patient 
is a question that cannot be answered in a word. 
Speaking generally women bear pain better than 
men. They endure a long illness better, both 
physically and morally. They are more patient 
and submissive, less defiant of fate and, I think I 
may add, more logical. There are exceptions, of 
course, but then there are exceptions in all things. 

Perhaps what the critic of gold calls the " acid 
test " is provided by the test of an operation. 
Here is something very definite to be faced. A 
man is usually credited with more courage than a 
woman. This is no doubt a just estimate in situa- 
tions of panic and violence where less is expected 
of a woman ; but in the cold, deliberate presence 
of an operation she stands out well. 

A display of courage in a man is instinctive, 
a feature of his upbringing, a matter of tradition. 
With women is associated a rather attractive ele- 
ment of timidity. It is considered to be a not 
indecorous attribute of her sex. It is apt to be 
exaggerated and to become often somewhat of a 
pose. A woman may be terrified at a mouse in her 
bedroom and yet will view the entrance into that 
room of two white-clad inquisitors — the anaesthetist 
and the surgeon — with composure. A woman will 
frankly allow, under certain conditions, that she 



Two Women 95 

is '' frightened to death " ; the man will not permit 
himself that expression, although he is none the 
less alarmed. A woman seldom displays bravado ; 
a man often does. To sum up the matter — a 
woman before the tribunal of the operating theatre 
is, in my experience, as courageous as a man, 
although she may show less resolve in concealing 
her emotions. 

In the determination to live, which plays no 
little part in the success of a grave operation, a 
woman is, I think, the more resolute. Her powers 
of endurance are often amazing. Life may hang 
by a thread, but to that thread she will cling as 
if it were a straining rope. I recall the case of a 
lady who had undergone an operation of unusual 
duration and severity. She was a small, fragile 
w^oman, pale and delicate-looking. The blow she 
had received would have felled a giant. I stood 
by her bedside some hours after the operation. 
She was a mere grey shadow of a woman in whom 
the signs of life seemed to be growing fainter and 
fainter. The heat of the body was maintained by 
artificial means. She was still pulseless and her 
breathing but a succession of low sighs. She evi- 
dently read anxiety and alarm in the faces of 
those around her, for, by a movement of her lips, 
she indicated that she wished to speak to me. I 



Two Women 

bent down and heard in the faintest whisper the 
words, " I am not going to die." She did not 
die; yet her recovery was a thing incredible. 
Although twenty-eight years have elapsed since 
that memorable occasion, I am happy to say that 
she is still alive and well. 

There are other traits in women that the 
surgeon comes upon which, if not actually peculiar 
to their sex, are at least displayed by them in 
the highest degree of perfection. Two of these 
characteristics — or it may be that the two are one 
— are illustrated by the incidents which follow. 

The first episode may appear to be trivial, 
although an eminent novelist to whom I told the 
story thought otherwise and included it, much 
modified, in one of his books. 

The subject was a woman nearing forty. She 
was plain to look at, commonplace and totally 
uninteresting. Her husband was of the same 
pattern and type, a type that embraces the 
majority of the people in these islands. He was 
engaged in some humdrum business in the city of 
London. His means were small and his life as 
monotonous as a downpour of rain. The couple 
lived in a small red-brick house in the suburbs. 
The house was one of twenty in a row. The twenty 
were all exactly alike. Each was marked by a 



Two Women 97 

pathetic pretence to be "a place in the country " ; 
each was occupied by a family of a uniform and 
wearying respectability. These houses were like 
a row of chubby inmates from an institution, all 
wearing white cotton gloves and all dressed alike 
in their best. 

The street in which the houses stood was called 
*' The Avenue," and the house occupied by the 
couple in question was named " The Limes." It 
was difficult to imagine that anything of real 
interest could ever occur in "The Avenue." It 
was impossible to associate that decorous road with 
a murder or even a burglary, much less with an 
elopement. The only event that had disturbed its 
peace for long was an occasion when the husband 
of one of the respected residents had returned home 
at night in a state of noisy intoxication. For 
months afterwards the dwellers in " The Avenue," 
as they passed that house, looked at it askance. 
It may be said, in brief, that all the villas were 
"genteel" and that all those who lived in them 
were " worthy." 

The plain lady of whom I am speaking had no 
children. She had been happy in a stagnant, 
unambitious way. Everything went well with 
her and her household, until one horrifying day 
when it was discovered that she had developed a 



9^ Two Women 

malignant tumour of the breast. The growth was 
operated upon by a competent surgeon, and for 
a while the spectre was banished. The event, of 
course, greatly troubled her; but it caused even 
more anxiety to her husband. The two were very 
deeply attached. Having few outside interests 
or diversions, their pleasure in life was bound up 
with themselves and their small home. 

The husband was a nervous and imaginative 
man. He brooded over the calamity that had 
befallen his cherished mate. He was haunted by 
the dread that the horrid thing would come back 
again. When he was busy at his office he forgot 
it, and when he was at home and with a wife who 
seemed in such beaming health it left his mind. 
In his leisure moments, however, in his journeyings 
to London and back and in sleepless hours of the 
night, the terror would come upon him again. 
It followed him like a shadow. 

Time passed; the overhanging cloud became 
less black and a hope arose that it would fade 
away altogether. This, however, was not to be. 
The patient began to be aware of changes at 
the site of the operation. Unpleasant nodules 
appeared. They grew and grew and every day 
looked angrier and more vicious. She had little 
doubt that " it " — the awful unmentionable thing 



Two Women 99 

— had come back. She dared not tell her husband. 
He was happy again ; the look of anxiety had left 
his face and everything was as it had been. To 
save him from distress she kept the dread secret 
and, although the loathsome thing was gnawing 
at her vitals, she smiled and maintained her wonted 
cheerfulness when he and she were together. 

She kept the secret too long. In time she 
began to look ill, to become pallid and feeble and 
very thin. She struggled on and laughed and joked 
as in the old days. Her husband was soon aware 
that something was amiss. Although he dared 
not express the thought, a presentiment arose in 
his mind that the thing of terror was coming back. 
He suggested that she should see her surgeon 
again, but she pooh-poohed the idea. *'Why 
should a healthy woman see a surgeon? " At 
last her husband, gravely alarmed, insisted, and 
she did as he wished. 

The surgeon, of course, saw the position at a 
glance. The disease had returned, and during the 
long weeks of concealment had made such progress 
that any operation or indeed any curative measure 
was entirely out of the question. Should he tell 
her ? If he told her what would be gained thereby ? 
Nothing could be done to hinder the progress of 
the malady. To tell her would be to plunge her 



\ 



100 Two Women 

and her husband into the direst distress. The 
worry that would be occasioned could only do her 
harm. Her days were numbered ; why not make 
what remained of her life as free from unhappiness 
as possible ? It was sheer cruelty to tell her. In- 
fluenced by these humane arguments he assured 
her it was all right, patted her on the back and 
told her to run away home. 

For a while both she and her husband were 
content. She was ready to believe that she had 
deceived herself and regretted the anxiety she had 
occasioned; but the unfortunate man did not 
remain long at ease. His wife was getting weaker 
and weaker. He wondered why. The surgeon 
said she was all right ; she herself maintained that 
she was well, but why was she changing so quickly.?* 
The doubt and the uncertainty troubled both of 
them ; so it was resolved that a second opinion 
should be obtained, with the result that she came 
to see me in London. 

A mere glimpse was enough to reveal the condi- 
tion of affairs. The case was absolutely hopeless 
as her surgeon, in a letter, had already told me. 
I was wondering how I should put the matter to 
her but she made the decision herself. She begged 
me to tell her the absolute truth. She was not 
afraid to hear it. She had plans to make. She 



Two Women loi 

had already more than a suspicion in her mind and 
for every reason she must know, honestly and 
openly, the real state of affairs. I felt that matters 
were too far gone to justify any further conceal- 
ment. I told her. She asked if any treatment was 
possible. I was obliged to answer " No." She 
asked if she would live six months and again I was 
compelled to answer " No." 

What happened when she left my house I 
learned later. It was on a Saturday morning in 
June that she came to see me. For her husband 
Saturday was a half-holiday and a day that he 
looked forward to with eager anticipation. So 
anxious was he as to my verdict that he had not 
gone to his business on this particular day. He 
had not the courage to accompany his wife to 
X<ondon and, indeed, she had begged him not to- 
be present at the consultation. He had seen his 
wife into the train and spent the rest of the morn- 
ing wandering listlessly about, traversing every 
street, road and lane in the neighbourhood in a 
condition of misery and apprehension. 

He knew by what train she would return, but 
he had not the courage to meet it. He would 
know the verdict as she stepped out of the carriage 
and as he caught a glimpse of her face. The plat- 
form would be crowded with City friends of his, 



102 Two Women 

and whatever the news— good or bad— he felt that 
he .would be unable to control himself. 

He resolved to wait for her at the top of " The 
Avenue," a quiet and secluded road. He could 
not, however, stand still. He continued to roam 
about aimlessly. He tried to distract his thoughts. 
He counted the railings on one side of a street, 
assuring himself that if the last railing proved 
to be an even number his wife would be all right. 
It proved to be uneven. He jingled the coins in 
his pocket and decided that if the first coin he 
drew out came up " Heads," it would be a sign 
that his wife was well. It came up "Heads." 
Once he found that he had wandered some way 
from " The Avenue " and was seized by the panic 
that he would not get back there in time. He 
ran back all the way to find, when he drew up, 
breathless, that he had still twenty-five minutes 
to wait. 

He thought the train .would never arrive. It 
seemed hours and hours late. He looked at his 
watch a dozen times. At last he heard the train 
rumble in and pull up at the station. The moment 
had come. He paced the road to and fro like a 
caged beast. He opened his coat the better to 
breathe. He took off his hat to wipe his streaming 
forehead. He watched the corner at v/hich she 



Two Women 103 

would appear. She came suddenly in sight. He 
saw that she was skipping along, that she was 
waving her hand and that her face was beaming 
with smiles. As she approached she called out, 
"It is all right! " 

He rushed to her, she told me, with a yell, 
threw his arms round her and hugged her until 
she thought she would have fainted. On the way 
to the house he almost danced round her. He 
waved his hat to everybody he saw and, on enter- 
ing the house, shook the astonished maid-servant 
so violently by the hand that she thought he was 
mad. 

That afternoon he enjoyed himself as he had 
never done before. The cloud was removed, his 
world was a blaze of sunshine again, his wife was 
saved. She took him to the golf links and went 
round with him as he played, although she was so 
weak she could hardly crawl along. His game was 
a series of ridiculous antics. He used the handle 
of his club on the tee, did his putting with a 
driver and finished up by giving the caddie half a 
sovereign. In the evening his wife hurriedly in- 
vited a few of his choicest friends to supper. It 
was such a supper as never was known in " The 
Avenue " either before or since. He laughed and 
joked, was generally uproarious, and finished by 



104 Two Women 

proposing the health of his wife in a rapturous 
speech. It was the day of his hfe. 

Next morning she told him the truth. 

I asked her why she had not told him at once. 
She replied, " It was his half-holiday and I wished 
to give him just one more happy day." 

The second episode belongs to the days of my 
youth when I was a house-surgeon. The affair 
was known in the hospital as " The Lamp Murder 
Case." It concerned a family of three — husband, 
wife and grown-up daughter. They lived in an 
ill-smelling slum in the most abject quarter of 
Whitechapel. The conditions under which this 
family existed were very evil, although not ex- 
ceptional in the dark places of any town. 

The husband was just a drunken loafer, vicious 
and brutal, and in his most fitting place when he 
was lying in the filth of the gutter. He had 
probably never done a day's work in his life. He 
lived on the earnings of his wife and daughter. 
They were seamstresses and those were the doleful 
days of " The Song of the Shirt." As the girl 
was delicate most of the work fell upon the mother. 
This wretched woman toiled day by day, from 
year's end to year's end, to keep this unholy family 
together. She had neither rest nor relaxation, 
never a gleam of joy nor a respite from unhappi- 



Two Women 105 

ness. The money gained by fifteen hours' con- 
tinuous .work with her needle might vanish in one 
uproarious drinking bout. Her husband beat her 
and kicked her as the fancy pleased him. He did 
not disable her, since he must have money for 
drink and she alone could provide it. She could 
work just as well with a black eye and a bruised 
body as without those marks of her lord's pleasure. 

As she had to work late at night she kept a 
a lamp for her table. One evening the sodden 
brute, as he staggered into the room, said that he 
also must have a lamp, must have a lamp of his 
own. What he wanted it for did not matter. He 
would have it. He was, as a rule, too muddled to 
read even if he had ever learnt to read. Possibly 
he wanted the lamp to curse by. Anyhow, if she 
did not get him a lamp to-morrow he would ' * give 
her hell," and the poor woman had already seen 
enough of hell. Next day she bought a lamp, lit 
it and placed it on the table with some hope no 
doubt in her heart that it would please him and 
bring a ray of peace. 

He came home at night not only drunk but 
quarrelsome. The two lamps were shining 
together on the table. The room was quite bright 
and, indeed, almost cheerful ; but the spectacle 
drove him to fury. He cursed the shrinking, tired 

H 



io6 Two Women 

woman. He cursed the room. He cursed the 
lamp. It was not the kind of lamp he wanted. It 
was not so good as her lamp and it was like her 
meanness to get it. As she stood up to show him 
ihow nice a lamp it really was he hit her in the face 
with such violence that he knocked her into a 
corner of the room. She was wedged in and unable 
to rise. He then took up his lamp and, with a 
yell of profanity, threw it at her as she lay on 
the ground. At once her apron and cotton dress 
were ablaze and, as she lay there burning and 
screaming for mercy, he hurled the other lamp at 
her. 

The place was now lit only by the horrible, 
dancing flames that rose from the burning woman. 
The daughter was hiding in terror in the adjoining 
room. The partition which separated it from her 
mother's was so thin that she had heard everything 
that passed. She rushed in and endeavoured to 
quench the flames ; but streams of burning oil were 
trickling all over the floor, while the saturated 
clothes on her mother's body flared like a wick. 
Her father was rolling about, laughing. He might 
have been a demon out of the Pit. Neighbours 
poured in and, by means of snatched-up fragments 
of carpet, bits of sacking and odd clothes, the fire 
was smothered ; but it was too late. 



Two Women 107 

There followed a period of commotion. A 
crowd gathered in the dingy lane with faces up- 
turned to the window from the broken panes of 
which smoke was escaping. People pressed up 
the stair, now thick with the smell of paraffin and 
of burning flesh. The room, utterly wrecked, was 
in darkness, but by the light of an unsteady candle 
stuck in a bottle the body of the woman, moaning 
with pain, was dragged out. An improvised 
stretcher was obtained and on it the poor seam- 
stress, wrapped up in a dirty quilt, was marched 
off to the hospital, followed by a mob. The 
police had appeared early on the scene and, acting 
on the evidence of the daughter, had arrested the 
now terrified drunkard. 

When the woman reached the hospital she was 
still alive but in acute suffering. She was taken 
into the female accident ward and placed on a bed 
in a corner by the door. The hour was very late 
and the ward had been long closed down for the 
night. It was almost in darkness. The gas jets 
were lowered and the little light they shed fell 
upon the white figures of alarmed patients sitting 
up in bed to watch this sudden company with 
something dreadful on a stretcher. 

A screen was drawn round the burnt woman's 
bed, and in this little enclosure, full of shadow, a 



io8 Two Women 

strange and moving spectacle came to pass. The 
miserable patient was burned to death. Her 
clothes were reduced to a dark, adhesive crust. 
In the layers of cinder that marked the front of 
her dress I noticed two needles that had evidently 
been stuck there when she ceased her work. Her 
face was hideously disfigured, the eyes closed, the 
lips swollen and bladder-like and the cheeks charred 
in patches to a shiny brown. All her hair was 
burnt off and was represented by a little greasy 
ash on the pillow, her eyebrows were streaks of 
black, while her eyelashes were marked by a 
line of charcoal at the edge of the lids. She 
might have been burnt at the stake at Smith- 
field. 

As she was sinking it was necessary that her 
dying depositions should be taken. For this pur- 
pose a magistrate was summoned. With him came 
two policemen, supporting between them the 
shaking form of the now partly-sobered husband. 
The scene was one of the most memorable I have 
witnessed. I can still see the darkened ward, the 
whispering patients sitting bolt upright in their 
nightdresses, the darker corner behind the screen, 
lit only by the light of a hand lamp, the motionless 
figure, the tray of dressings no longer needed, the 
half-emptied feeding-cup. I can recall too the 



Two Women 109 

ward cat, rudely disturbed, stalking away with a 
leisurely air of cynical unconcern. 

The patient's face was in shadow, the nurse 
and I stood on one side of the bed, the magistrate 
was seated on the other. At the foot of the bed 
were the two policemen and the prisoner. The 
man — who was in the full light of the lamp — was 
a disgustful object. He could barely stand ; his 
knees shook under him ; his hair was wild ; his eyes 
blood-shot; his face bloated and bestial. From 
time to time he blubbered hysterically, rock- 
ing to and fro. Whenever he looked at his 
wife he blubbered and seemed in a daze until 
a tug at his arm by the policeman woke 
him up. 

The magistrate called upon me to inform 
the woman that she was dying. I did so. She 
nodded. The magistrate then said to her — 
having warned her of the import of her evidence 
— " Tell me how this happened." She replied, 
as clearly as her swollen lips would allow, " It 
was a pure accident." 

These were the last words she uttered, for she 
soon became unconscious and in a little while was 
dead. She died with a lie on her lips to save the 
life of the brute who had murdered her, who had 
burned her alive. She had lied and yet her words 



no Two Women 

expressed a dominating truth. They expressed 
her faithfulness to the man who had called her 
wife, her forgiveness for his deeds of fiendish 
cruelty and a mercy so magnificent as to be 
almost divine. 



A SEA LOVER 



\ 
\ 



\ 

\ 



VI 

A SEA LOVER 

THE man I would tell about was a mining 
engineer some forty and odd years of age. 
Most of his active life had been spent in Africa 
whence he had returned home to England with 
some gnawing illness and with the shadow of 
death upon him. He was tall and gaunt. The 
tropical sun had tanned his face an unwholesome 
brown, while the fever-laden wind -of the swamp 
had blanched the colour from his hair. He was 
a tired-looking man who gave one the idea that 
he had been long sleepless. He was taciturn, for 
he had lived much alone and, but for a sister, had 
no relatives and few friends. For many years he 
had wandered to and fro survejnng and prospect- 
ing, and when he turned to look back upon the 
trail of his life there was little to see but the ever- 
stretching track, the file of black porters, the 
solitary camp. 

The one thing that struck me most about him 

was his love of the sea. If he was ill, he said, it 

113 



114 A Sea Lover 

must be by the sea. It was a boyish love evidently 
which had never died out of his heart. It seemed 
to be his sole fondness and the only thing of which 
he spoke tenderly. 

He was born, I found, at Salcombe, in Devon- 
shire. At that place, as many know, the sea rushes 
in between two headlands and, pouring over rocky 
terraces and around sandy bays, flows by the 
little town and thence awaj^ up the estuary. At 
the last it creeps tamely among meadows and 
cornfields to the tottering quay at the foot of 
Kingsbridge. 

On the estuary he had spent his early days, 
and here he and a boy after his own heart had 
made gracious acquaintance with the sea. When 
school was done the boys were ever busy among 
the creeks, playing at smugglers or at treasure 
seekers so long as the light lasted. Or they hung 
about the wharf, among the boats and the pic- 
turesque litter of the sea, where they recalled in 
ineffable colours the tales of pirates and the Spanish 
Main which they had read by the winter fire. The 
reality of the visions was made keener when they 
strutted about the deck of the poor semi-domestic 
coaling brig which leaned wearily against the 
iharbour side or climbed over the bulwarks of the 
old schooner, which had been wrecked on the 



A Sea Lover 115 

beach before they were born, with all the dash of 
buccaneers. 

In their hearts they were both resolved to 
"follow the sea" but fate turned their footsteps 
elsewhere, for one became a mining engineer in 
the colonies and the other a clerk in a stock- 
broker's office in London. 

In spite of years of uncongenial work and of 
circumstances which took them far beyond the 
paradise of tides and salt winds the two boys, as 
men, ever kept green the memory of the romance- 
abounding sea. He who was to be a clerk became 
a pale-faced man who wore spectacles and whose 
back was bent from much stooping over books. 
I can think of him at his desk in the City on some 
day in June, gazing through a dingy window at a 
palisade of walls and roofs. The clerk's pen is 
still, for the light on the chimney-pots has changed 
to a flood of sun upon the Devon cliffs, and 
the noise of the streets to the sound of waves 
tumbling among rocks or bubbling over pebbles. 
There are sea-gulls in the air, while far away a 
grey barque is blown along before the freshening 
breeze and the only roofs in view belong to the 
white cottages about the beach. Then comes 
the ring of a telephone bell and the dream 
vanishes. 



ii6 A Sea Lover 

So with the man whose Kfe was cast in un- 
kindly lands. He would recall times when the 
heat in the camp was stifling, when the heartless 
plain shimmered as if it burnt, when water was 
scarce and what there was of it was warm, 
while the torment of insects was beyond bear- 
ing. At such times he would wonder how the 
tide stood in the estuary at home. Was the 
flood swirling up from the Channel, bringing 
with its clear eddies the smell of the ocean as 
it hurried in and out among the piles of the old 
pier.f* Or was it the time of the ebb when 
stretches of damp sand come out at the foot 
of cliffs and when ridges of rock, dripping 
with cool weed, emerge once more into the 
sun ? What a moment for a swim ! Yet here 
on the veldt there was but half a pint of 
water in his can and a land stretching before 
him that was scorched to cracking, dusty and 
shadowless. 

It was in connexion with his illness that I came 
across him. His trouble was obscure, but after 
much consideration it was decided that an opera- 
tion, although a forlorn hope, should be attempted. 
If the disease proved to be benign there was pros- 
pect of a cure ; if a cancer was discovered the 
outlook was hopeless. 



A Sea Lover 117 

He settled that he would have the operation 
performed at the seaside, at a town on the south 
coast, within easy reach of London. Rooms were 
secured for him in a house on the cliffs. From the 
windows stretched a fine prospect of the Channel, 
while from them also could be seen the little 
harbour of the place. 

The surgeon and his assistant came down from 
London and I with them. The room in which 
the operation was to be performed was hard and 
unsympathetic. It had been cleared of all its 
accustomed furniture. On the bare floor a white 
sheet had been placed, and in the middle of this 
square stood the operation table like a machine of 
torture. Beyond the small bed the patient was to 
occupy and the tables set out for the instruments 
the room was empty. Two nurses were busy with 
the preparations for the operation and were gossip- 
ing genially in whispers. There was a large bow- 
window in the room of the type much favoured at 
seaside resorts. The window was stripped of its 
curtains so that the sunlight poured in upon the 
uncovered floor. It was a cloudless morning in 
July. 

The hard-worked surgeon from London had a 
passion for sailing and had come with the hope that 
he might spend some hours on the sea after his 



ii8 A Sea Lover 

iwork was done. His assistant and I were to go 
with him. 

When all the preparations for the operation 
were completed the patient walked into the room 
erect and unconcerned. He stepped to the table 
and, mounting it jauntily, sat on it bolt upright 
and gazed out earnestly at the sea. Following his 
eyes I could see that in the harbour the men were 
already hoisting the mainsail of the little yawl in 
which we were to sail. 

The patient still sat up rigidly, and for so long 
that the surgeon placed a hand upon his shoulder 
to motion him to lie down. But he kept fixedly 
gazing out to sea. Minutes elapsed and yet he 
moved not. The surgeon, with some expression of 
anxiety, once more motioned him to lie down, but 
still he kept his look seawards. At last the rigid 
muscles relaxed, and as he let his head drop upon 
the pillow he said, " I have seen the last of it — 
the last of the sea — you can do what you like with 
oie now." He had, indeed, taken, as he thought, 
farewell of his old love, of the sea of his boyhood 
and of many happy memories. The eyes of the 
patient closed upon the sight of the English 
Channel radiant in the sun, and as the mask of the 
anaesthetist was placed over his face he muttered, 
" I have said good-bye." 



A Sea Lover 119 

The trouble revealed by the surgeon proved to 
be cancer, and when, some few days after the 
operation, the weary man was told the nature of 
his malady he said, with a smile, he would take 
no more trouble to live. In fourteen days 
he died. 

Every day his bed ,was brought close to the 
window so that the sun could fall upon him, so 
that his eyes could rest upon the stretch of water 
and fhe sound of waves could fall upon his tired 
ears. 

The friend of his boyhood, the clerk, came down 
from London to see him. They had very little 
to say to one another when they met. After the 
simplest greeting was over the sick man turned his 
face towards the sea and for long he and his old 
companion gazed at the blue Channel in silence. 
There was no need for speech. It was the sea that 
spoke for them. It was evident that they were both 
back again at Salcombe, at some beloved creek, 
and that they were boys once more playing by 
the sea. The sick man's hand moved across the 
coverlet to search for the hand of his friend, and 
when the fingers met they closed in a grip of 
gratitude for the most gracious memory of their 
lives. 

The failing man's last sight of the sea was 



120 A Sea Lover 

one evening at sundown when the tide was 
swinging away to the west. His look Hngered 
upon the fading waves until the night set 
in. Then the blind of the window was drawn 
down. 

Next morning at sunrise it was not drawn up, 
for the lover of the sea was dead. 



A CASE OF "HEART FAILURE" 



VII 

A CASE OF "HEART FAILURE" 

WHAT a strange company they are, these 
old patients who crowd into the surgeon's 
memory after a Hfetime of busy practice ! There 
they stand, a confused, impersonal assembly, so 
illusive and indisiinct as to be little more than 
shadows. Behind them is a dim background of 
the past — a long building wdth many windows that 
I recognize as my old hospital, a consulting room 
with familiar furniture, an operating theatre, 
certain indefinite sick-rooms as well as a ward in 
which are marshalled a double row of beds with 
blue and white coverlets. 

Turning over the pages of old case books, as 
one would idle with the sheets of an inventory, 
some of these long departed folk appear clearly 
enough, both as to their faces and the details of 
their histories ; but the majority are mere ghosts 
with neither remembered names nor features, 
neither age nor sex. They are just fragments of 
anatomy, the last visible portions of figures that 

are fading out of sight. Here, among the crowd, 

123 



124 A Case of "Heart Failure" 

are the cheeks of a pretty girl encircled by white 
bandages and the visage of a toothless old man 
with only one ear. I can recollect nothing but 
their looks. They belong to people I have known, 
somewhere and somehow, in the consulting room 
or the ward. Here a light falls upon " that 
knee," "that curious skull," "that puzzling 
growth." Here is a much distorted back, bare 
and pitiable, surmounted by coils of beautiful 
brown hair. If the lady turned round I should 
probably not recognize her face ; but I remember 
the back and the coils of hair. 

This is a gathering, indeed, not of people, but 
of " cases " recalled by portions of their bodies. 
The collection is not unlike a medley of fragments 
of stained glass with isolated pieces of the human 
figure painted upon them, or it may be comparable 
to a faded fresco in a cloister, where the portions 
that survive, although complete in themselves, 
fail to recall the story they once have told. 

It is curious, when so much is indefinite, how 
vividly certain trivial items stand forth as the sole 
remains of a once complete personality. All I 
can recall of one lady — elderly but sane — was the 
fact that she alwaj^s received me, during a long 
illness, sitting up in bed with a large hat on her 
head trimmed with red poppies. She also wore 



A Case of "Heart Failure" 125 

a veil, which she had to lift in order that I might 
see her tongue. She was further distinguished by 
a rose pinned to her nightdress, but I recall with 
relief that she did not wear gloves. 

Of one jolly boy the only particular that 
survives in my mind is a hare's foot which was 
found under his pillow when he was awaiting an 
operation. It had been a talisman to coax him 
to sleep in his baby days, when his small hand 
would close upon it as the world faded. His old 
" nanny " had brought it to the nursing home, 
and had placed it secretly under his pillow, know- 
ing that he would search for it in the unhappy 
daze of awakening from chloroform. He wept 
with shame when it was discovered, but I am sure 
it was put back again under the pillow, although 
he called his " nanny " " a silly old thing." 

Then, again, there was the whistling girl. 
She was about sixteen, and had recently learnt 
whistling from a brother. Her operation had 
been serious, but she was evidently determined to 
face it sturdily and never to give way. She 
expressed herself by whistling, and the expression 
,was even more realistic than speech. Thus as I 
came upstairs the tone of her whistling was defiant 
and was intended to show that she was not the 
least afraid. During the dressing of the wound 



126 A Case of " Heart Failure " 

the whistling was subdued and uncertain, a 
rippling accompaniment that conveyed content 
when she was not hurt, but that was interrupted 
by a staccato '* whoo " when there was a dart of 
pain. As soon as my visit was over the music 
became debonair and triumphant, so that I often 
left the room to the tune of Mendelssohn's 
"Wedding March." 

On the other hand, among the phantoms of 
the case book are some who are remembered with 
a completeness which appears never to have grown 
dim. The figures are entire, while the inscription 
that records their story is as clear as it was when 
it w^as written. 

In the company of these well remembered 
people is the lady whose story is here set forth. 
More than thirty years have passed since I saw 
her, and yet I can recall her features almost as 
well as if I had met her yesterday, can note again 
her little tricks of manner and the very words 
she uttered in our brief conferences. She was 3 
woman of about twenty-eight, small and fragile, 
and very pretty. Her face was oval, her com- 
plexion exquisite, while her grey-blue eyes had in 
them the look of solemn wonder so often seen 
in the eyes of a child. Her hair came down low 
on either side of her face, and was so arranged 



A Case of *' Heart Failure " 127 

as to remind me of the face of some solemn lady 
in an old Italian picture. Her mouth was small 
and sensitive, but determined, and she kept her 
lips a little apart when listening. She was quiet 
and self-possessed, while her movements and her 
speech were slow, as if she were weary. 

She was shown into my room at an hour when 
I did not, as a rule, receive patients. She came 
without appointment and without any letter of 
introduction from her doctor. She said that she 
had no doctor, that she came from a remote place 
in the north of England, that she had an idea what 
was the matter with her, and that she wanted me 
to carry out the necessary operation. On investi- 
gation I found that she had an internal growth 
which would soon imperil her life. I explained 
to her that an operation would be dangerous and 
possibly uncertain, but that if it proved successful 
her cure would be complete. She said she would 
have the operation carried out at once, and asked 
me to direct her to a nursing home. She displayed 
neither anxiety nor reasonable interest. Her mind 
was made up. As to any danger to her life, the 
point was not worth discussing. 

She had informed me that she was married, 
but had no children. I inquired as to her parents, 
but she replied that she was an orphan. I told 



128 A Case of " Heart Failure " 

her that I must write fully both to her doctor and 
to her husband. She rephed, as before, that she 
had no doctor, and that it seemed a pity to worry 
a strange medical man with details about a patient 
who was not under his care. As to her husband, 
she asked if I had told her all and if there would 
be anything in my letter to him that I had not 
communicated to her. I said that she knew the 
utmost I had to tell. " In that case," she replied, 
" a note from you is unnecessary." I said, " Of 
course, your husband will come up to London? " 
To which she remarked, " I cannot see the need. 
He has his own affairs to attend to. Why should 
any fuss be made? The operation concerns no 
one but myself." 

I asked her then what relative or friend would 
look after her during the operation. She said, 
"No one. I have no relatives I care about; 
and as to friends, I do not propose to make my 
operation a subject for gossip." I explained to 
her that under such circumstances no surgeon 
would undertake the operation. It was a 
hazardous measure, and it was essential that she 
should have someone near her during a period of 
such anxiety. She finally agreed to ask an elderly 
lady — a remote connexion of hers — to be with 
her during her stay in the nursing home. 



A Case of " Heart Failure " 129 

Still, there was some mystery about the lady 
that I could not fathom, something evidently that 
I did not know. There was a suggestion of reck- 
lessness and even of desperation in her attitude 
that it was difficult to account for. As she sat in 
the chair by the side of my desk, with her hands 
folded in her lap and her very dainty feet crossed 
in front of her, her appearance of indifference was 
so pronounced that no onlooker would imagine 
that the purport of our converse was a matter of 
life and death. One little movement of hers 
during our unemotional talk was recalled to my 
mind some days later. She now and then put her 
hand to her neck to finger a brooch in the collar 
of her dress. It was a simple gold brooch, but 
she appeared to derive some comfort, or it may 
be some confidence, from the mere touching 
of it. 

The operation was effected without untoward 
incident of any kind. It was entirely successful. 
The wound healed by what is known as ' ' first 
intention," there was no rise of temperature and 
no surgical complication. But the condition of 
the patient caused an uneasiness that deepened 
day by day. She became restless and apathetic 
and at the same time very silent, answering 
questions only in monosyllables. She resisted no 



130 A Case of " Heart Failure *' 

detail of treatment, but accepted everything with 
a lethargic complacency impossible to overcome. 

That, however, was not all. She appeared to 
be possessed by an indefinite anxiety which was 
partly expressed by an intense attitude of expecta- 
tion. She was expecting a letter, looking out for 
it day after day and hour after hour. She listened 
to the door and to any sound on the stair as an 
imprisoned dog might listen for the steps of its 
master. This terrible vigil began on the second 
or third day after the operation. When I made 
my visit about that time she asked me if I had 
given orders that she was to have no letters. I 
assured her I had not done so and that she should 
have every letter the moment it arrived. But no 
letter came. 

Whenever I made my appearance her first 
question was, " Did you see a letter for me in the 
halU " I could only answer " No." Then she 
would press me with other inquiries : '* How often 
does the postman come.^ Is he not sometimes 
late? Has there been any accident on the rail- 
way? Do letters get occasionally lost in the 
post? " and so on interminably. If anyone came 
into the room there was always a look of expecta- 
tion on her face, an eager searching for a letter in 
the hand or on a tray. If a knock w^as heard at 



A Case of "Heart Failure*' 131 

the front door, she at once inquired if it was the 
postman, and very usually asked me to go to the 
top of the stair to ascertain. 

The sisters, the nurses and the patient's friend 
could tell me nothing. No letter of any kind 
arrived. The poor, tormented creature's yearning 
for a letter had become a possession. I inquired 
if she had written any letters herself. The sister 
said that, as far as was known, she had written 
but one, and that was on the eve of her operation. 
Although she should have been in bed at the time, 
she insisted on going out for the purpose of posting 
the letter herself. 

She rapidly became weaker, more restless, 
more harassed by despair. She was unable to 
sleep without drugs and took scarcely any food. 
Feeble and failing as she was, her anxiety about 
the coming of a letter never abated. I asked a 
physician versed in nervous disorders to see her, 
but he had little to propose. She was evidently 
dying — but of what? 

She was now a pitiable spectacle, emaciated 
and hollow-eyed, with a spot of red on her cheek, 
an ever- wrinkled brow and ever-muttering lips. 
I can see to this day the profile of her lamentable 
features against the white background of the 
pillow. Pinned to the pillow was the brooch that 



132 A Case of " Heart Failure 



)j 



I had noticed at her neck when I saw her in my 
consulting room. She would never allow it to 
be removed, but gave no reason for her insistence. 
I have seen her hand now and then move up to 
touch it, just as she had done during our first 
interview. 

I was with her when she died. As I entered 
the room there was still the same expectant 
glance at the door. Her lips, dry and brown, 
appeared to be shaping the question, " A letter 
for me? " There was no need to answer " No." 
At the very last — with a display of strength that 
amazed me — she turned over with her face to the 
wall as if she wished to be alone ; then, in a voice 
louder than I had known her to be capable of 
for days, she cried out," Oh, Frank! Frank! " 
and in a moment later she was dead. 

Her death was certified, with unconscious 
accuracy, as due to " heart failure." 

Here was a mystery, and with it a realization 
of how little we knew of this lady who had died 
because she wished to die. I was aware that her 
husband's christian name was William, but beyond 
that I knew practically nothing of him. The 
sister of the nursing home had both written and 
telegraphed to the husband, but no reply had been 
received. It was afterwards ascertained that he 



A Case of " Heart Failure " 133 

was away at the time and that the house was 
shut up. 

I was determined to find out the meaning of 
the tragedy, but it was some months before I was 
possessed of the whole of the story. The poor 
lady's marriage had been unhappy. Her husband 
had neglected her, and they were completely 
estranged. She formed a friendship with a man 
of middle age who lived near by. This is he 
whose christian name was Frank and who was, I 
imagine, the giver of the brooch. The friendship 
grew into something more emotional. She 
became, indeed, desperately attached to him, 
and he to her. Their intimacy was soon so 
conspicuous as to lead to gossip in the neighbour- 
hood, while the state of the two lovers themselves 
was one of blank despair. She looked to him as 
Pompillia looked to Caponsacchi. He was her 
saviour, her '* soldier saint, the lover of her life." 
To him she could repeat Pompillia's words : " You 
are ordained to call and I to come." 

It became evident in time that the only course 
the two could adopt was to run away together. 
She, on her part, counted no cost and would have 
followed him blindly to the world's end. He, on 
the other hand, hesitated. He did count the cost 
and found it crushing. His means were small. 



134 A Case of " Heart Failure " 

His future depended on himself. An elopement 
would involve ruin, poverty and squalor as well 
as, in time, a fretful awakening from a glorious 
dream. 

He did the only thing possible. He told her 
that they must part, that he must give her up, 
that he must not see her again, that he must not 
even write to her. It was a wise and, indeed, 
inevitable decision ; but to her it seemed to fore- 
tell the end of her life. He kept the compact, 
but she had not the strength to accept it. It was 
something that was impossible. She endeavoured 
to get in touch with him again and again, and in 
many ways, but without success. Hard as it was, 
he had kept to his resolve. 

Then came the episode of the operation. Now, 
she thought, if she wrote to him to say that she 
was in London and alone and that she was about 
to undergo an operation that might cause her 
death, he must come to see her or he must at 
least reply to her letter. She felt assured that 
she would hear from him at last, for, after all 
that had passed between them, he could not deny 
her one little word of comfort in this tragic 
moment. 

She wrote to him on the eve of her operation. 
The rest of the story I have told. 



A RESTLESS NIGHT 



VIII 

A RESTLESS NIGHT 

IT was in Rajputana, in the cold weather, that 
,we came upon the dak bungalow. I was 
proceeding south from a native state where I had 
met an officer in the Indian Medical Service. 
He was starting on a medical tour of inspection, 
and for the first stage of the journey we travelled 
together. He was glad to have a member of 
his own profession to talk to. 

towards the end of the day we halted at this 
dak bungalow. It was situated in a poor waste 
which was possessed of two features only — dried 
earth and cactus bushes. So elemental was the 
landscape that it might have been a part of the 
primeval world before the green things came into 
being. The cactus, bloated, misshaped and scarred 
by great age, looked like some antediluvian growth 
which had preceded the familiar plants with leaves. 
If a saurian had been in sight browsing on this 
ancient scrub the monster would have been in 
keeping. Some way distant across the plain was 

a native village, simple enough to be a settle- 
J 137 



138 A Restless Night 

ment of neolithic men. Although it was but a 
splash of brown amidst the faded green it conveyed 
the assurance that there were still men on the 
earth. 

The bungalow was simple as a packing-case. 
It showed no pretence at decoration, while there 
was in its making not a timber nor a trowel of 
plaster which could have been dispensed with. 
In the centre of the miserly place was a common 
room with a veranda in front and a faintly- 
suggested kitchen at the back. Leading out of 
the common room, on either side, was a bedroom, 
and the establishment was complete. The central 
room was provided with one meal-stained table and 
two dissolute-lookmg chairs of the kind found in 
a servant's attic. The walls were bare save for 
certain glutinous splashes where insects had been 
squashed by the slipper of some tormented guest. 
The place smelt of grease and paraffin, toned by 
a faint suggestion of that unclean aromatic odour 
which clings to Indian dwellings. The bedrooms 
were alike — square chambers with cement floors, 
plain as an empty water-tank. An inventory of 
their respective contents was completed by the 
following items — one low bedstead void of bed- 
ding, one chair, one table with traces of varnish 
in places and one looking-glass in a state of 



A Restless Night 139 

desquamation. To these may be added one 
window and two doors. One door led into the 
common room, the other into a cemented bath- 
room containing a battered tin bath, skinned 
even of its paint. 

We each o£ us had an Indian servant or bearer 
who, with mechanical melancholy, made the toilet 
table pretentious by placing upon it the entire 
contents of our respective dressing bags. 

After dinner, of a sort, we sat on the peni- 
tential chairs and smoked, leaning our elbows on 
the table for our greater comfort. The doctor 
was eloquent upon his medical experiences in 
the district, upon his conflicts with pessimistic 
patients and his struggles with fanaticism and 
ignorance. The average sick man, he told me, 
had more confidence in a dried frog suspended 
from the neck in a bag than in the whole British 
Pharmacopoeia. Most of his narratives have 
passed out of my memory, but one incident I 
had reason to remember. 

It concerned a native from the adjacent village 
who was working as a stone-mason and whose eye 
was pierced by a minute splinter of stone. As a 
result the eye became inflamed and sightless, save 
that the man retained in the damaged organ an 
appreciation of light. As bearing upon the case 



140 A Restless Night 

and its sequel I must explain the circumstances of 
" sympathetic ophthalmia." When an eye is 
damaged as this was, and inflammation ensues, it 
is not uncommon for the mischief to spread to the 
sound globe and destroy that also. In order to 
prevent such a catastrophe it is necessary to remove 
the injured and useless eye as promptly as possible. 
That was the uniform practice in my time. The 
operation in question was urged upon the native 
an order to prevent sympathetic ophthalmia in the 
sound eye, but he declined it, preferring to consult 
a magician who lived a day's journey from the 
village. The consultation took place and the man 
returned to the local dispensary ; for although he 
still had good vision in the sound eye it was 
beginning to trouble him. 

The surgeon considered that the operation was 
now probably too late ; but he yet urged it upon 
the ground that there was some prospect of success, 
while, on the other hand, failure could make the 
patient's condition no more desperate. The man, 
persuaded against his will, at last consented, and 
the useless eyeball was removed. Unfortunately 
the operation wm too late ; the sound eye became 
involved beyond recovery and the miserable native 
found himself totally blind. He ignorantly 
ascribed his loss of sight to the operation. 



A Restless Night 141 

Before my friend left the station the man was 
brought into his room for the last time, and when 
it was explained to him that he was in the doctor's 
presence he threw his arms aloft and, shrieking 
aloud, cursed the man of healing with a vehemence 
which should have brought down fire from heaven. 
He called upon every deity in the Indian myth- 
ology to pour torments upon this maimer of men, 
to blast his home and annihilate his family root 
and branch. He blackened the sky with curses 
because the darkness which engulfed him pre- 
vented him from tearing out with his nails the 
eyes of this murderous Englishman. Foaming and 
screaming, and almost voiceless from the violence 
of his speech, he was led away to stumble about 
his village, where for weeks he rent the air with 
his awful imprecations. Whether the poor man 
was now alive or dead the doctor could not say, 
for he had heard no more of him. 

In due course we agreed that the time had 
come to go to bed. The doctor said that he always 
occupied the right-hand bedroom when he came 
to the bungalow, but as it was found that my 
servant had deposited my bedding and effects in 
this particular sepulchre, he retired to the chamber 
across the hall. 

I did not look forward to a night in this so 



142 A Restless Night 

called '' Rest House." The bedroom was as com- 
fortless as a prison cell and as desolate as the one 
sound room in a ruin. There was some comfort 
in contemplating the familiar articles displayed on 
the dressing-table, yet they looked curiously out 
of place. 

I locked the door leading to the common room, 
but found that the door to the bathroom had no 
lock; while there was merely a bolt to the outer 
door that led from the bathroom into the open. 
This bolt I shot, but left the intermediate door 
ajar, feeling that I should like to assure myself 
from time to time that the far room was empty. 
There was one small paraffin lamp provided, but 
the glass shade of it had been broken, so that it 
iwas only when the wick was very low that it would 
burn without smoking. By the glimmer of this 
malodorous flame I undressed and, blowing it out, 
got into bed. 

The place was as black as a pit, as stifling and 
as silent. I lay awake a long time, for the still- 
ness was oppressive. I found myself listening to 
it. It seemed to be made up of some faint, far-off 
sounds of mysterious import of which I imagined 
I could catch the rhythm. It was possible tc 
believe that these half-imagined pulsations were 
produced by the rush of the earth through space, 



A Restless Night 143 

and that the stillness of the night made them 
audible. 

I went to sleep in time and slept — as I after- 
wards discovered — for some hours, when I was 
aroused by a noise in the room. I was wideawake 
in an instant, with my head raised off the pillow, 
listening rigidly for the sound that I must have 
heard in my sleep. The place was in solid dark- 
ness. I felt that there was something alive in the 
room, something that moved. 

At last the sound came again. It was the 
pattering of the feet of some animal. The creature 
was coming towards the bed. I could hear others 
moving along the floor, always from the bathroom, 
until the place seemed to be alive with invisible 
creatures. Such is the effect of imagination that 
I conceived these unknown animals to be about 
the size of retrievers. I wondered if their heads 
would reach the level of the couch, until I was 
relieved to hear that many were now running about 
under the bed. I resolved to shout at them but 
fancied that the noise of my own voice would be 
as unpleasant to hear as the voice of another and 
unknown human being in the room. 

I noticed now a faint odour of musk, and was 
glad to think that these pattering feet belonged 
to musk-rats, and that these animals must have 



144 A Restless Night 

entered through the drain hole I had observed 
in the outer wall of the bathroom. I dislike rats, 
and especially rats in a bedroom. This prejudice 
was not made less when I felt that some of them 
were climbing up on to the bed. I was certain 
I could hear one crawling over my clothes which 
lay on the chair by the bedside. I was certain 
that others were searching about on the dressing- 
table, and recognized — or thought I did — the 
clatter of a shoe-horn that lay there. I recalled 
stories in which men had been attacked by hordes 
of rats, and I wondered when they would attack 
me, for, by this time, the whole room seemed 
to be full of rats, and I could picture legions 
swarming in from the plain outside in a long 
snake-like column. 

In a while I was sure that a rat was on the 
pillow close to my head. My hair seemed to be 
flicked by the whiskers of one of these foetid 
brutes. This was more than I could tolerate, so 
I sprang up in bed and shouted. There was a 
general scuttle for the far door; but it was some 
time before I ventured to pass my hand over the 
pillow to assure myself that a rat was not still 
there. 

I had a mind to get out of bed and light the 
lamp ; but to do this seemed to be like taking a 



A Restless Night 145 

step into a black pit. I lay down again. For a 
while all was quiet. Then came once more the 
pattering of feet from the direction of the bath- 
room, the sickly odour of musk and a conviction 
that at least a hundred rats were pouring into the 
room. They crept up to the bed and ran about 
beneath it with increasing boldness. I was 
meditating another shout when there came a sound 
in the room that made every vein in my body 
tingle. It arose from under the bed, a hollow 
scraping sound which I felt sure was due to the 
movement of a human being. I thought it was 
caused by the scraping of a belt buckle on the 
cement floor, the belt being worn by a man who 
was crawling on his stomach. I disliked this sound 
more than the rats. 

At this moment, to add to my discomfort, I 
felt a rat crawling across my bare foot, a beast 
with small, cold paws and hot fur. I kicked it off 
so that it fell with a thud on the floor. I shouted 
again and, driven to desperation, jumped out of 
bed. I half expected to tread on a mass of rats, 
but felt the hard floor instead. I went to the 
dressing-table and struck a light. The place was 
empty, but I could not see under the bed. The 
match went out and in the blackness I expected 
some fresh surprise to develop. I managed 



146 A Restless Night 

to strike another match and to light the 
lamp. 

I placed it on the floor and looked under the 
bed. What I saw there I took at first to be a 
piece of a human skull. I got a stick and touched 
it. It seemed lighter than a dried bone. I 
dragged it out into the room. It was a cake of 
unleavened bread, much used by the natives — 
dried up into a large curled chip. The rats had 
been dragging this away and had so produced the 
scraping sound which I had exaggerated into some- 
thing sinister. 

Having convinced myself that the room was 
empty I blocked up the drain-hole in the outer wall 
by placing the bath in front of it and, feeling 
secure from any further disturbance, returned to 
bed, leaving the lamp alight on the table. 

For a long time I kept awake, watching every 
now and then the bathroom door to satisfj'- myself 
that I had succeeded in keeping the beastly animals 
out. During this vigil I fell asleep and then at 
once embarked upon a dream, the vividness and 
reahty of which were certainly remarkable. 

The most convincing feature was this. The 
dream, without a break, continued the happenings 
of the night. The scene was this identical bedroom 
at this identical moment. The dream, as it were. 



A Restless Night 147 

took up the story from the moment that I lost 
it. Owing to my close scrutiny every detail of 
the vile chamber had already become as clearly 
impressed upon my brain as if it had been fixed 
by a photographic plate. I had not — in my dream 
— fallen asleep again, but .was still wideawake and 
still keeping a watch over the bathroom door for 
the incoming of the rats. 

The bathroom door was just ajar, but the very 
faint glimmer of the lamp did not enable me to 
penetrate the darkness that filled it. I kept my 
eye fixed on the entry when, in a moment, to my 
horror, the door began to open. The sight was 
terrifying in the extreme. My heart was thumping 
to such a degree that I thought its beats must be 
audible. I felt a deadly sinking in my stomach, 
while the skin of my back and neck seemed to be 
,wrinkling and to be dragged up as might be a 
shirt a man is drawing over his head. There is no 
panic like the panic felt in a dream. 

A brown hand appeared on the edge of the 
door. It was almost a relief to see that it was a 
human hand. The door was then opened to its 
utmost. Out of the dark there crept a middle- 
aged man, a native, lean and sinewy, without a 
vestige of clothing on his body. His skin shone in 
the uncertain light, and it was evident that his 



148 A Restless Night 

body, from head to foot, was smeared with oil. 
The most noticeable point about the man was that 
he was blind. His eyelids were closed, but the 
sockets of his eyes were sunken as are those of a 
corpse. With his left hand he felt for the wall, 
while in his right hand he carried a small stone- 
mason's pick. His face was expressionless. This 
was the most terrible thing about it, for his face 
was as the face of the dead. He crept into the 
room as Death himself might creep into the 
chamber of the dying. 

I realized at once in my dream that this was 
the native about whom my friend had been speak- 
ing before we had retired for the night. This 
man had heard of the doctor's arrival, would 
know my room as the one he usually occupied, 
and had now come there to murder him. 

I was so fascinated by the sight of this 
unhuman creature moving towards me that I 
could not stir a muscle. I was raised up in bed, 
and w^as leaning on one elbow like an image on 
a tomb. I was so filled with the sense of a final 
calamity that I felt I had ceased to breathe. 
There were, indeed, such a clutching at my throat 
and such a bursting at my heart that the act of 
breathing seemed wellnigh impossible. Had I 
been awake I should, without doubt, have shouted 



A Restless Night 149 

at the uncanny intruder and attacked him, but in 
the dream I was unable to stir, and the longer I 
remained motionless the more impossible did it 
appear that I could move. My limbs might have 
been turned into stone. 

The figure crept on, feeling his way by the 
wall. There was a sense of an oncoming, 
irresistible fate. Every time that a horrible bare 
foot was lifted, advanced and brought to the 
ground I felt that I was one step nearer to the 
end. The figure seemed to grow larger as it 
approached me. The hand, \vith outstretched 
fingers, that groped its way along the wall was 
like a claw. I could hear the breathing of the 
creature, the breath being drawn in between the 
closed teeth. I could see the muscles of the arm 
that held the pick contract and relax. There was 
now in the air the loathsome smell of the unclean 
native mixed with the odour of oil. 

One more step and he was so near that I could 
see the faint light glimmer on his teeth and could 
notice that they were dry. The outstretched, 
claw-like hand that felt its way along the wall was 
now nearly over my head. In another moment 
that awful pick would crash into my skull or 
plunge into my neck. I bowed my head instinc- 
tively so that I should not see the blow coming. 



150 A Restless Night 

and at the same time I thought it would be less 
terrible if the iron were driven into my back 
rather than into my head or face. 

The evil creature was now close to the bed. 
The extended arm was clawing along the wall 
above my pillow, for I had now shrunken as low 
as I could. With my head bent I could now see 
nothing of the man but his wizened thigh, upon 
which the muscles rose and fell. A bony knee-cap 
was advanced slowly, and then I saw a shadow 
move on the floor. This I felt was the shadow 
of the arm with the pick raised to strike. 

I was mesmerized as would be a rabbit in a 
corner within a foot of a snake. Suddenly the 
lamp flame gave a little crackle. The sound, 
breaking the silence, was intensified into an 
explosion. It seemed to call me to my senses. 
With one maddened half-conscious effort I rolled 
gently off the bed, away from the pursuer, and 
slipped, between the couch and the wall, on to 
the floor. 

I made little noise in doing this, for my body 
was uncovered, the bed was very low, and the 
space between it and the wall so narrow that I 
was let slowly down to the ground. To the blind 
man I may merely have turned in bed. 

As I lay there on the floor I could see the two 



A Restless Night 151 

sinewy feet close to the couch and could hear the 
awful hand moving stealthily over the very pillow. 
I next knew that he was bending over the couch 
to find what was between the bed and the wall. 
Turning my head, I saw a shadowy hand descend 
on the far side of the bed, the fingers extended 
as if feeling the air. In a moment he would reach 
me. His hand moved to and fro like the head of 
a cobra, while I felt that with a touch of his 
tentacle-like fingers I should die. The climax of 
the dream was reached. 

I was now well under the bed. In a paroxysm 
of despair I seized the two skinny ankles and 
jerked them towards me, at the same moment 
lifting the frail bed bodily with my back so that 
it turned over on its side away from the wall. 
The wretch's feet being suddenly drawn away 
from him, he fell heavily backwards upon the bare 
floor, his head striking the stone with a hollow 
sound. The edge of the bedstead lay across him. 
The feet, which I still held, were nerveless, and 
he made no movement to withdraw them. I crept 
back clear of the bed and, jumping upright against 
the wall, bolted through the bathroom and out 
into the plain. I had a glimpse of the man as I 
went by. He was motionless and his mouth hung 
open. 



152 A Restless Night 

I ran some way from the bungalow before I 
stopped. I was like a man saved from the scaffold 
as the very axe was about to drop. There was a 
gentle air blowing, cool and kindly. Above was 
a sky of stars, while in the east the faint light 
of the dawn was appearing behind the Indian 
village. 

For a moment or two I watched the door 
leading from the bathroom, expecting to see the 
man with the pick creep out, but the anticipation 
of the sight was so dread that I turned away and 
walked to the other side of the bungalow. Here 
my greatest joy was merely to breathe, for I 
seemed to have been for hours in a suffocating 
pit. 

The relief did not last for long. I was seized 
with another panic. Had I killed the man? I 
felt compelled to return to the abhorred room and 
learn the worst. I approached it with trembling. 
So curious are the details of a dream that I found 
— as I expected — the bolt on the outer door 
wrenched off and hanging by a nail. I stepped 
into the disgusting place, full of anxiety as to 
what further horror I had to endure. The little 
lamp was still alight. The bedstead was on its 
edge as I left it, but the man was gone. There 
was a small patch of blood where his head had 



A Restless Night 153 

struck the floor, but that was the sole relic of the 
tragedy. 

I awoke feeling exhausted, alarmed and very 
cold. I looked at once at the floor for the patch 
of blood, and, seeing nothing, realized, to my 
extreme relief, that I had been merely dreaming. 
It was almost impossible to believe that the events 
of the latter part of the night, after the departure 
of the rats, had not been real. At breakfast I 
retailed to my companion the very vivid and 
dramatic nightmare in which I had taken part. 
At the end he expressed regret for the mistake 
the servants had made in allotting us our rooms 
overnight, but I am not sure that that regret 
was perfectly sincere. 



IN ARTICULO MORTIS 



IX 

IN ARTICULO MORTIS 

THE recent work on " Death and its 
Mystery,"^ by Camille Flammarion, the 
eminent astronomer, cannot fail to be of supreme 
interest. The second vohime of the series, 
entitled "At the Moment of Death," will more 
especially appeal to medical men, and it is with 
this volume and with the reminiscences it has 
aroused that I am at present concerned. 

About the act or process of dying there is no 
mystery. The pathologist can explain precisely 
how death comes to pass, while the physiologist 
can describe the exact physical and chemical pro- 
cesses that ensue when a living thing ceases to 
live. Furthermore, he can demonstrate how the 
material of the body is finally resolved into the 
elements from which it was formed. 

The mystery begins in the moment of death, 
and that mystery has engaged the thoughts and 
imaginations of men since the dawn of human 
existence. It was probably the first problem that 

1 Fisher Unwin, London, 1922. 

157 



158 In Articulo Mortis 

presented itself to the inquisitive and ingenious 
mind, and it may be that it will be the last to 
occupy it. Beyond the barrier of death is "the 
undiscovered country " where a kindly light falls 
upon Elysian Fields or happy hunting grounds, or 
fills with splendour the streets of an eternal city. 
To some, on the other hand, there is no such 
country but only an impenetrable void, a blank, 
a mere ceasing to be. Certain who read these 
tworks of the learned astronomer may perhaps feel 
that he has thrown light upon the great mystery. 
Others may affirm that he leaves that mystery still 
unillumined and wholly unsolved, while others 
again may think that he makes the mystery still 
more mysterious and more complex. 

M. Flammarion deals with the manifestations 
of the dying, with agencies set in action by the 
dying, and with events which attend upon the 
moment of death. He affirms that in addition 
to the physical body there is an astral body or 
"psychic element" which is "imponderable and 
gifted with special, intrinsic faculties, capable of 
functioning apart from the physical organism, and 
of manifesting itself at a distance." 

This leads to the theory of bilocation where the 
actual body (at the point of death) may be in one 
place and the astral body in another. It is this 



In Articulo Mortis 159 

power of bilocation which explains the phantasms 
and apparitions of which the book gives many 
detailed records. These apparitions may be objec- 
tive — that is to say, may be visible to several people 
at the same time — or they may be subjective or 
capable of being perceived only by the subject or 
seer. " These apparitions," the author states, 
" are projections emanating from the soul of the 
dying." They are astral bodies detached for the 
moment from the physical body of which they are 
part. "It is," the author continues, " at the 
hour of death that transmissions of images and of 
sensations are most frequent" (p. 108). 

These phantasms appear, either in dreams or 
in broad daylight, to the friends of dying persons. 
They may announce in words, " I am dying," or 
** I am dead." They may merely appear with 
signs upon their faces of alarm or of impending 
dissolution. They may appear as bodies lying 
dead upon a couch or in a coffin. They may pre- 
dict the hour of their death, but more usually 
their appearance coincides with the exact moment 
at which their physical bodies ceased to exist. 

M. Flammarion gives numerous instances of 
these apparitions seen under such varying circum- 
stances as have been named. In certain examples 
the phantom appears to have substance and to be 



i6o In Articulo Mortis 

capable of making its presence actually felt. Thus 
in one case the subject saw the apparition of her 
sister who was dying in a place far away, and at 
the same time ' ' felt a hand brush lightly against 
the sheets." The subject, when questioned, said : 
"No, no, it wasn't a dream! I heard her 
steps ; they made the floor creak. I'm sure of 
it; I wasn't dreaming; she came; I saw her" 
(p. 345). 

It may be further noted that persons who 
announce their deaths to others by visions or by 
spoken words may at the time of such warning 
be in perfect health. Moreover, the apparition may 
announce to the dreamer the exact date of the 
speaker's own death many days in advance. In 
one such instance a man — then in sound health 
— appeared to a friend in a dream on August 2 
and informed him that he (the subject of the 
apparition) would die on August 15. The event 
happened as foretold. An instance which in- 
volved an interval of years is recorded by Robert 
Browning the poet. Seven years after his wife's 
death she appeared in a dream to her sister. Miss 
Arabel Barrett. Miss Barrett asked the appari- 
tion, " When will the day come on which we 
shall be reunited? " The dead woman answered, 
" My dear, in five years." Five years, lacking a 



In Articulo Mortis i6i 

month, after this vision, Miss Barrett died of heart 
disease. 

In messages or warnings from the dying M. 
Flammarion affirms that telepathy (or the trans- 
mission of thought to a distance) plays an im- 
portant part. 'More than this, he says : " It is 
beyond doubt that at the moment of death a subtle 
shock, unknown in its nature, at times affects those 
at a distance who are connected with the dying 
person in some way. This connexion is not 
always that of sympathy." The method in which 
telepathy acts is explained b}^ the author in the 
following words: " It is admitted that a kind of 
radiation emanates from the dying person's brain, 
from his spirit, still in his body, and is dispersed 
into space in ether waves — successive, spherical 
waves, like those of sound in the atmosphere. 
When this wave, this emanation, this effluvium, 
comes into contact with a brain attuned to receive 
it, as in the case of a wireless-telegraph apparatus, 
the brain comprehends it — feels, hears, sees " 
(p. 284). 

The manifestations produced by these passages 
between the living and those who are on the point 
of death are very varied. They may take the form 
of warnings, predictions or notifications of death. 
They may be conveyed vast distances and are 



i62 In Articulo Mortis 

usually received at the very moment at which the 
body from which they emanate ceases to be. 
Warnings or announcements may be conveyed by 
voices or by visions of various kinds. The voices 
may be recognized as those of the dying, or the 
actual death scene, " visioned from a distance," 
may be presented complete in every detail. Some 
of the manifestations may take a physical form, 
such as knockings upon doors and windows, the 
sound of footsteps or of gliding feet, the moving 
of articles of furniture, the falling of portraits from 
the wall, the opening of doors, the passage of a 
gust of wind. 

Many of the phenomena appear to me to be 
hardly worthy of being recorded. As illustrations 
I may quote the movement of a hat on a hat peg 
used by the deceased, the violent shaking of an 
iron fender to announce a daughter's death, the 
fact that about the time of a relative's decease a 
table became " split completely along its whole 
length," while on another like occasion a gas jet 
went out in a room in which a party was sitting, 
playing cards. 

The following circumstance will not commend 
itself to the reasonable as one that was dependent 
upon a supernatural agency. " My grandmother," 
a student writes, " died in 1913. At the hour of 



In Articulo Mortis 163 

her death the clock which hung in her room 
stopped, and no one could make it go again. Some 
years afterwards her son died, and the very day of 
his death the clock again began to go without 
anyone having touched it." "It is strange," 
comments M. Flammarion, "that the spirit of 
someone dying or dead should be able to stop a 
clock or start it again." Assuredly it is more 
than strange. The same comment might apply to 
the following testimony provided by a gardener 
in Luneville. " A friend, when one day cleaning 
vegetables, seated in a chair, was struck on the 
knee by a turnip which was on the ground, and 
heard at the same instant two cries : ' Mother ! 
Mother ! ' That same day her son, a soldier, 
was dying in our colony of Guiana ; she did not 
hear of his death until very much later." 

M. Flammarion's work is probably the most 
orderly, temperate and exact that has appeared 
on the subject of death from the point of view of 
the spiritualist. It has been the work of many 
years and its conclusions are based upon hundreds 
of reports, letters and declarations collected by the 
writer. To many readers the book will, no doubt, 
be convincing and inspiring, while possibly to a 
larger number of people the author's position will 
appear to be untenable, and much of the evidence 



164 In Articulo Mortis 

upon which his conclusions are based to be 
either incredible or impossible. With those who 
may hold this latter opinion I am entirely in 
accord. 

Many of the so-called manifestations, such as 
the spirit visitants, the visions and the voices, can 
be as fitly claimed to be illusions and hallucina- 
tions as ajfirmed to be due to the action of the 
psychic element or astral body. The tricks of 
the senses are innumerable. The imagination, 
stimulated and intensified, can effect strange 
things in sensitive subjects ; while, on the other 
hand, the powers of self-deception are almost 
beyond belief, as the experience of any physician 
will attest. Belief in the supernatural and the 
miraculous has a fascination for many minds, and 
especially for minds of not too stable an order. 
Such persons seem to prefer a transcendental 
explanation to one that is commonplace. 
Apparitions are not apt to appear to those who 
are healthy both in body and in mind. Dreams, 
it will be admitted by all, are more often due to 
indigestion than to a supernatural or a spiritual 
agency. Voices are heard and non-existing things 
^re seen by those whose minds are deranged, and 
it must be allowed that not a few of the men and 
women upon whose evidence M. Flammarion de- 



In Articulo Mortis 165 

pends exhibit a degree of emotional excitement 
or exaltation which borders on the abnormal. 

I think, moreover, it would not be unjust to 
suggest that certain of the narratives are exag- 
gerated and that an element of invention is 
possible and, indeed, probable in many of them. 
There is an impression also that some of the circum- 
stances detailed have been misinterpreted or mis- 
applied or have been modified by events which 
have followed later and to which they have been 
adapted as an afterthought. Above all I am 
reluctant to believe that the dying, in the solemn 
and supreme moment of passing away from the 
earth, can be occupied by the trivialities — and, 
indeed, I would say by the paltry tricks — which 
are accredited to their action in this book. 

It is only fair to point out that the volume 
now discussed is written by an eminent man of 
science who has been trained all his life in methods 
of precision, in the judicial examination of reported 
facts and in the close scrutiny of evidence. Further 
it may be said that the terms "incredible" and 
' ' impossible ' ' would have been applied a few years 
ago to any account of the telephone or of wire- 
less telegraphy, while the same expressions would 
assuredly be employed by a medical man when 
told, not so long since, that there was a ray capable 



i66 In Articulo Mortis 

of making a human body so transparent as to 
render visible not only the bones but the details 
of their internal construction. 

In common with others who have been for 
many years on the staff of a large hospital, I have 
seen much of death and have heard even more 
from those who have been in attendance on the 
dying. In this experience of a lifetime I have 
never met with a single circumstance which would 
confirm or support the propositions advanced by 
M. Flammarion. This is obviously no argument. 
It is merely a record of negative experience. 
The only two events, within my personal know- 
ledge, which bear even remotely upon the present 
subject are the following. 

I was, as a youth, on a walking tour in the 
south of England with a cousin. We put up one 
night at a certain inn. In the morning my com- 
panion came down to breakfast much excited and 
perturbed. He declared that his father was dead, 
that in a vivid dream he had seen him stretched 
out dead upon the couch in his familiar bedroom 
at home. He had awakened suddenly and noted 
that the hour was 2 a.m. That his father had 
expired at that moment he was assured, so assured 
that he proposed to return home at once, since 
his mother was alone. Inasmuch as the journey 



In Articulo Mortis 167 

would have occupied a whole day, I suggested 
that, before starting, he should telegraph and seek 
news of his father. With great reluctance he 
consented to this course and the telegram was 
dispatched. A reply was received in due course. 
It was from the father himself expressing surprise 
at the inquiry and stating that he was never better 
in his life. Nothing, it transpired, had disturbed 
the father's rest at 2 a.m. on this particular night. 
Nothing untoward happened. My uncle lived for 
many years, and finally died one afternoon, and 
not, therefore, at 2 a.m. 

The other incident is associated with an actual 
death and with a strange announcement, but the 
announcement is not to be explained by any of 
the theories propounded by M. Flammarion. The 
facts are these. I was on a steamship which was 
making a passage along that coast known in old 
days as the Spanish Main. We put in at Colon, 
and remained there for about a day and a half. I 
took advantage of this break in the voyage to 
cross the Isthmus by train to Panama. The 
names of those who were travelling by the train 
had been telegraphed to that city, which will 
explain how it came about that on reaching the 
station I was accosted by one of the medical 
officers of the famous American hospital of the 



i68 In Articulo Mortis 

place. He begged me to see with him a patient 
under his care. The sick man was an EngUshman 
who was traveUing for pleasure, who was quite 
alone and who had been taken ill shortly after 
his arrival on the Pacific. He was the only 
Englishman, he said, on that side of the 
Isthmus. 

I found the gentleman in a private ward. 
He was a stranger to me, was very gravely ill, 
but still perfectly conscious. I had nothing fresh 
to suggest in the way of treatment. The case was 
obviously hopeless, and we agreed that his life 
could not be extended beyond a few days and 
certainly not for a week. It was a satisfaction 
to feel that the patient was as well cared for as if 
he had been in his own home in England. I 
returned to Colon. Travelling with me was a 
retired general of the Indian Army. He had 
remained at Colon during my absence. I told 
him my experience. He did not know the patient 
even by name, but was much distressed at the 
thought of a fellow-countryman dying alone in 
this somewhat remote part of the world. This 
idea, I noticed, impressed him greatly. 

Two days after my return from Panama we 
were on the high seas, having touched at no port 
since leaving Colon, On the third day after my 



In Articulo Mortis 169 

visit to the hospital the general made a curious 
communication to me. The hour for lunch on 
the steamer was 12.15. My friend, as he sat down 
to the table, said abruptly, " Your patient at 
Panama is dead. He has just died. He died at 
12 o'clock." I naturally asked how he had 
acquired this knowledge, since we had called 
nowhere, there was no wireless installation on the 
ship, and we had received no message from any 
passing vessel. Apart from all this was the 
question of time, for the death, he maintained, 
had only just occurred. He replied, *' I cannot 
say. I was not even thinking of the poor man. 
I only know that as the ship's bell was striking 
twelve I was suddenly aware that he had, at that 
moment, died." The general, I may say, was a 
man of sturdy common sense who had no belief 
in the supernatural, nor in emanations from the 
dying, nor in warnings, nor in what he called 
generally " all that nonsense." Telepathy — in 
which also he did not believe — was out of the 
question, since he and the dead man were 
entirely unknown to one another. My friend 
was merely aware that the news had reached him. 
It was useless for me to say that I did not think 
the patient could have died so soon, for the 
general remained unmoved. He only knew that 



170 In Articulo Mortis 

the man was dead whether I expected the event 
or whether I did not. 

When we reached Trinidad I proposed to go 
ashore to ascertain if any news had arrived of the 
death at Panama. The general said it was waste 
of time. The man was dead, and had died at 
noon. Nevertheless, I landed and found that a 
telegram had appeared in which the death of this 
lonely gentleman was noted as having taken place 
on the day I have named. The hour of his 
death was not mentioned, but on my return to 
England I was shown by his relatives the actual 
cablegram which had conveyed to them the news. 
It stated that he had died at Panama on that 
particular day at twelve o'clock noon. No 
coincidence could have been more precise. 

The general, to whom the event was as 
mysterious as it was unique in his experience, 
ventured one comment. He said that during his 
long residence in India he had heard rumours of 
the transmission of news from natives in one part 
of India to natives in another, which reports — 
if true — could not be explained by the feats of 
runners nor by any system of signalling, since 
the distances traversed were often hundreds of 
miles. We were both aware of the rumour, 
current at the time, that the news of the defeat 



In Articulo Mortis 171 

at Colenso was known in a certain Indian bazaar 
a few hours after the guns had ceased firing. 
This, we agreed, was assuredly an example of 
loose babble — started by a native who hoped to 
hear of the failure of the British — and that this 
gossip had become, by repetition, converted into 
a prophecy after the occurrence. 

For my own part I must regard the Panama 
incident as nothing but a remarkable coincidence 
of thought and event. My friend was inclined 
to regard it as an example of the sudden trans- 
mission of news of the kind suggested by his 
Indian experience. Why he of all people should 
have been the recipient of the message was beyond 
his speculation, since he had no more concern 
with the happenings at Panama than had the 
captain of the ship, to whom I had also spoken 
of the occurrence. 

A further subject of some interest, suggested 
by M. Flammarion's work, may be touched upon. 
In the contemplation of the mystery of death it 
may be reasonable to conjecture that at the 
moment of dying, or in the first moment after 
death, the great secret would be, in whole or in 
part, revealed. There are those who believe that 
after death there is merely the void of non- 
existence, the impenetrable and eternal night of 



172 In Articulo Mortis 

nothingness. Others conceive the spirit of the 
dead as wandering, somewhere and somehow, 
Ibeyond the Hmits of the world. It is this behef 
which has induced many a mother, after the 
death of her child, to leave the cottage door 
open and to put a light in the window with some 
hope that the wandering feet might find a way 
home. Others, again, hold to the conviction that 
those who die pass at once into a new state of 
existence, the conditions of which vary according 
to the faith of the believer. 

In the face of the great mystery it would be 
thought that those who have returned to life after 
having been, for an appreciable time, apparently 
dead might have gained some insight into the 
unknown that lies beyond. Cases of such recovery 
are not uncommon, and not a few must have 
come within the experience of most medical men 
of large practice. I have watched certain of such 
cases with much interest, i^mong them the most 
pronounced example of apparent lifelessness was 
afforded by the following occasion. 

A middle-aged man, in good general health, 
was brought into the theatre of the London 
Hospital to undergo an operation of a moderate 
degree of severity. The administration of an 
auEesthetic was commenced, but long before the 



In Articulo Mortis 173 

moment for operating arrived the man collapsed 
and appeared to be dead. His pulse had stopped, 
or at least no pulse could be detected, the heart- 
beat could not be felt, he had ceased to breathe, 
all traces of sensation had vanished, and his 
countenance was the countenance of the dead. 
Artificial respiration was at once employed, 
injections of various kinds were given, electricity 
was made extended use of, while the heat of the 
body was maintained by hot bottles liberally 
disposed. 

The man remained without evidence of life 
for a period so long that it seemed to be 
impossible that he could be other than dead. In 
the intense anxiety that prevailed, and in the 
excitement aroused, I have no doubt that this 
period of time was exaggerated and that seconds 
might have been counted as minutes ; but it 
represented, in my own experience, the longest 
stretch of time during which a patient has 
remained apparently without life. Feeble indica- 
tions of respiration returned and a flutter at the 
wrist could again be felt, but it was long before 
the man was well enough to be moved back to 
the ward, the operation having been, of course, 
abandoned. 

I determined to watch the recovery of con- 



174 In Articulo Mortis 

sciousness in this instance, for here was a man 
who had been so far dead that, for a period almost 
incredible to believe, he had been without the 
signs and evidences of life. If life be indicated 
by certain manifestations, he had ceased to live. 
He was, without question, apparently dead. It 
seemed to me that this man must have penetrated 
so far into the Valley of the Shadow of Death 
that he should have seen something of what was 
beyond, some part, at least, of the way, some 
trace of a path, some sight of a country. The door 
that separates life from death was in his case surely 
opening. Had he no glimpse as it stood ajar? 

He became conscious very slowly. He looked 
at me, but I evidently conveyed no meaning to 
his mind. He seemed gradually to take in the 
details of the ward, and at last his eye fell upon 
the nurse. He recognized her, and after some 
little time said, with a smile, " Nurse, you never 
told me what you heard at the music hall last 
night." I questioned him later as to any experi- 
ence he may have had while in the operating 
theatre. He replied that, except for the first 
unpleasantness of breathing chloroform, he 
remembered nothing. He had dreamed nothing. 

At a recent meeting (1922) of the British 
Medical Association at Glasgow Sir William 



In Articulo Mortis 175 

MacEwen reports an even more remarkable case 
of a man who was brought into the hospital as 
"dead." He had ceased to breathe before 
admission. An operation upon the brain was 
performed without the use of an anaesthetic of 
any kind. During the procedure artificial 
respiration was maintained. The man recovered 
consciousness and, looking round with amazement 
at the operating theatre and the strange gather- 
ing of surgeons, dressers and nurses, broke his 
death-like silence by exclaiming, "What's all 
this fuss about? " It is evident from cases such 
as these that no light upon the mystery is likely 
to be shed by the testimony of those who have 
even advanced so far as to reach at least the 
borderland of the "undiscovered country." 

I might conclude this fragment with some 
comment on the Fear of Death. The dread of 
death is an instinct common to all humanity. 
Its counterpart is the instinct of self-preservation, 
the resolve to live. It is not concerned with the 
question of physical pain or distress, but is the 
fear of extinction, a dread of leaving the world, 
with its loves, its friendships and its cherished 
individual affairs, with perhaps hopes unrealized 
and projects incomplete. It is a dread of which 
the young know little. To them life is eternal. 



176 In Articulo Mortis 

The adventure is before them. Death and old 
age are as far away as the blue haze of the 
horizon. It is about middle age that the 
realization dawns upon men that life does not last 
for ever and that things must come to an end. 
As the past grows vaster and more distant and 
the future lessens to a mere span, the dread of 
death diminishes, so that in extreme old age it 
may be actually welcomed. 

Quite apart from this natural and instinctive 
attitude of mind there is with many a poignant 
fear of death itself, of the actual act of dying 
and of the terror and suffering that may be 
thereby involved. This fear is ill-founded. The 
last moments of life are more distressing to 
.witness than to endure. What is termed " the 
agony of death " concerns the watcher by the 
bedside rather than the being who is the subject 
of pity. A last illness may be long, wearisome 
and painful, but the closing moments of it are, 
as a rule, free from suffering. There may appear 
to be a terrible struggle at the end, but of this 
struggle the subject is unconscious. It is the 
onlooker who bears the misery of it. To the 
subject there is merely a moment — 

"When something hke a white wave of the sea 
Breaks o'er the brain and buries us in sleep." 



In Articulo Mortis 177 

Death is often sudden, may often come during 
sleep, or may approach so gradually as to be almost 
unperceived. Those who resent the drawbacks of 
old age may take some consolation from the fact 
that the longer a man lives the easier he dies. 

A medical friend of mine had among his 
patients a very old couple who, having few 
remaining interests in the world, had taken up 
the study and arrangement of their health as a 
kind of hobby or diversion. To them the subject 
was like a game of "Patience," and was treated 
in somewhat the same way. They had made an 
arrangement with the doctor that he should look 
in and see them every morning. He would find 
them, in the winter, in a cosy, old-fashioned room, 
sitting round the fire in two spacious arm-chairs 
which were precisely alike and were precisely 
placed, one on the right hand and one on the left. 
The old lady, with a bright ribbon in her lace cap 
and a shawl around her shoulders, would generally 
have some knitting on her knees, while the old 
gentleman, in a black biretta, would be fumbling 
with a newspaper and a pair of horn spectacles. 

The doctor's conversation every morning was, 
of necessity, monotonous. He would listen to 
accounts of the food consumed, of the medicine 
taken and of the quantity of sleep secured, just 



178 In Articulo Mortis 

as he would listen to the details of a game of 
" Patience." Now and then there would be some 
startling " move," some such adventure as a walk 
to the garden gate or the bold act of sitting for 
an hour at the open window. After having 
received this report he would compliment the 
lady on her knitting and on the singing of her 
canary and would discuss with the gentleman such 
items of news as he had read in the paper. 

On one morning visit he found them as usual. 
The wife was asleep, with her spectacles still in 
place and her hands folded over her knitting. 
The canary was full of song. The midday beef 
tea was warming on the hob. The old gentle- 
man, having dealt with his health, became very 
heated on the subject of certain grievances, such 
as the noise of the church bells and the unseemly 
sounds which issued from the village inn. He 
characterized these and like disturbances of the 
peace as " outrages which were a disgrace to the 
country." After he had made his denunciation 
he said he felt better. 

Your wife, I see, is asleep," said the doctor. 
Yes," replied the old man; "she has been 
asleep, I am glad to say, for quite two hours, 
because the poor dear had a bad night last 
night." The doctor crossed the room to look at 






In Articulo Mortis 179 

the old lady. She was dead, and had, indeed, 
been dead for two hours. Such may be the last 
moments of the very old. 

Quite commonly the actual instant of death 
is preceded, for hours or days, by total uncon- 
sciousness. In other instances a state of semi- 
consciousness may exist up to almost the last 
moment of life. It is a dreamy condition, free 
of all anxiety, a state of twilight when the 
familiar landscape of the world is becoming very 
indistinct. In this penumbra friends are recog- 
nized, automatic acts are performed, and remarks 
are uttered which show, or seem to show, both 
purpose and reason. It is, however, so hazy a 
mental mood that could the individual return to 
life again no recollection of the period would, I 
think, survive. It is a condition not only free 
from uneasiness and from any suspicion of alarm, 
but is one suggestive even of content. 

I was with a friend of mine — a solicitor — at 
the moment of his death. Although pulseless 
and rapidly sinking, he was conscious, and in the 
quite happy condition just described. I suggested 
that I should rearrange his pillows and put him in a 
more comfortable position. He replied, " Don't 
trouble, my dear fellow ; a lawyer is comfortable in 
any position." After that he never spoke again. 



i8o In Articulo Mortis 

In connexion with this semi-somnolent state 
it is interesting to note how certain traits of 
character which have been dominant during Ufe 
may still survive and assert themselves — it may 
be automatically — in those whose general con- 
sciousness is fading away in the haze of death. 
The persistence of this ruling passion or phase of 
mind was illustrated during the last moments of 
an eminent literary man at whose death-bed I 
was present. This friend of mine had attained 
a position of great prominence as a journahst. 
He had commenced his career as a reporter, and 
the reporter's spirit never ceased to mark the 
intellectual activities of his later life. He was 
always seeking for information, for news, for some 
matter of interest, something to report. His 
conversation, as one acquaintance said, consisted 
largely of questions. He always wanted to know. 
When he was in extremis, but still capable of 
recognizing those around him, the dire sound of 
rattling in his throat commenced. He indicated 
that he wanted to speak to me. I went to his 
bedside. He said, in what little voice remained, 
" Tell me : Is that the death rattle? " I replied 
that it was. " Thank you," he said, with a faint 
shadow of a smile; " I thought so." 



THE IDOL V/ITH HANDS OF CLAY 



X 

THE IDOL WITH HANDS OF CLAY 

THE good surgeon is born, not made. He 
is a complex product in any case, and often 
something of a prodigy. His qualities cannot 
be expressed by diplomas nor appraised by 
university degrees. It may be possible to 
ascertain what he knows, but no examination can 
ehcit what he can do. He must know the human 
body as a forester knows his wood ; must know 
it even better than he, must know the roots and 
branches of every tree, the source and wanderings 
of every rivulet, the banks of every alley, the 
flowers of every glade. As a surgeon, moreover, 
he must be learned in the moods and troubles of 
the wood, must know of the wild winds that may 
rend it, of the savage things that lurk in its 
secret haunts, of the strangling creepers that may 
throttle its sturdiest growth, of the rot and mould 
that may make dust of its very heart. As an 
operator, moreover, he must be a deft handicrafts- 
man and a master of touch. 

He may have all these acquirements and yet 

183 



i84 The Idol with Hands of Clay 

be found wanting; just as a man may succeed 
when shooting at a target, but fail when faced by 
a charging lion. He may be a clever manipulator 
and yet be mentally clumsy. He may even be 
brilliant, but Heaven help the poor soul who has 
to be operated upon by a brilliant surgeon. 
Brilhancy is out of place in surgery. It is 
pleasing in the juggler who plays with knives in 
the air, but it causes anxiety in an operating 
theatre. 

The surgeon's hands must be delicate, but 
they must also be strong. He needs a lace- 
maker's fingers and a seaman's grip. He must 
have courage, be quick to think and prompt to 
act, be sure of himself and captain of the venture 
he commands. The surgeon has often to fight for 
another's life. I conceive of him then not as a 
massive Hercules wrestling ponderously with 
Death for the body of Alcestis, but as a nimble 
man in doublet and hose who, over a prostrate 
form, fights Death with a rapier. 

These reflections were the outcome of an 
incident which had set me thinking of the equip- 
ment of a surgeon and of what is needed to fit 
him for his work. The episode concerned a young 
medical man who had started practice in a humble 
country town. His student career had been 



The Idol with Hands of Clay 185 

meritorious and indeed distinguished. He had 
obtained an entrance scholarship at his medical 
school, had collected many laudatory certificates, 
had been awarded a gold medal and had become 
a Fellow of the Royal College of Surgeons. His 
inclination was towards surgery. He considered 
surgery to be his metier. Although circumstances 
had condemned him to the drab life of a family 
doctor in a little town, he persisted that he was, 
first and foremost, a surgeon, and, indeed, on 
his door-plate had inverted the usual wording and 
had described himself as " surgeon and physician." 
In his hospital days he had assisted at many 
operations, but his opportunities of acting as a 
principal had been few and insignificant. In a 
small practice in a small town surgical oppor- 
tunities are rare. There was in the place a 
cottage hospital with six beds, but it was mostly 
occupied by medical cases, by patients with 
rheumatism or pneumonia, by patients who had 
to submit to the surgical indignity of being 
poulticed and of being treated by mere physic. 
Cases worthy of a Fellow of the Royal College 
of Surgeons were very few, and even these seldom 
soared in interest above an abscess or a broken 
leg. 

Just before the young doctor settled down to 



M 



i86 The Idol with Hands of Clay 

practise he married. It was a very happy union. 
The bride was the daughter of a neighbouring 
farmer. She had spent her life in the country, 
was more famiUar with the ways of fowls and 
ducks than with the ways of the world, while a 
sunbonnet became her better than a Paris toque. 
She was as pretty as the milkmaid of a pastoral 
picture with her pink-and- white complexion, her 
laughing eyes and her rippled hair. 

Her chief charm was her radiant delight in 
the mere joy of living. The small world in which 
she moved was to her always in the sun, and the 
sun was that of summer. There was no town so 
pretty as her little town, and no house so perfect 
as "the doctor's" in the High Street. "The 
doctor's " was a Georgian house with windows 
of many panes, with a fanlight like a surprised 
eyebrow over the entry and a self-conscioUs brass 
knocker on the door. The house was close to the 
pavement, from which it was separated by a line 
of white posts connected by loops of chain. 
Passers-by could look over the low green wooden 
blinds into the dining-room and see the table 
covered with worn magazines, for the room was 
intended to imitate a Harley Street waiting- 
room. They could see also the bright things on 
the sideboard, the wedding-present biscuit box. 



The Idol with Hands of Clay 187 

the gong hanging from two cow-horns and the 
cup won at some hospital sports. To the young 
wife there never was such a house, nor such 
furniture, nor such ornaments, nor, as she 
went about with a duster from room to room, 
could there be a greater joy than that of keeping 
everything polished and bright. 

Her most supreme adoration, however, was for 
her husband. He was so handsome, so devoted, 
and so amazingly clever. His learning was 
beyond the common grasp, and the depths of his 
knowledge unfathomable. When a friend came 
in at night to smoke a pipe she would sit silent 
and open-mouthed, lost in admiration of her 
husband's dazzling intellect. How glibly he 
would talk of metabolism and blood-pressure ; 
how marvellously he endowed common things 
with mystic significance when he discoursed upon 
the value in calories of a pound of steak, or upon 
the vitamines that enrich the common bean, or 
even the more common cabbage. It seemed to 
her that behind the tiny world she knew there 
was a mysterious universe with which her well- 
beloved was as familiar as was she with the 
contents of her larder. 

She was supremely happy and content, while 
her husband bestowed upon her all the affection 



i88 The Idol with Hands of Clay 

of which he was capable. He was naturally vain, 
but her idolatry made him vainer. She considered 
him wonderful, and he was beginning to think 
her estimate had some truth in it. She was so 
proud of him that she rather wearied her friends 
by the tale of his achievements. She pressed 
him to allow her to have his diploma and his 
more florid certificates framed and hung up in 
the consulting room, but he had said with chill- 
ing superiority that such things '* were not 
done," so that she could only console herself by 
adoring the modesty of men of genius. 

One day this happy, ever-busy lady was seized 
with appendicitis. She had had attacks in her 
youth, but they had passed away. This attack, 
although not severe, was graver, and her husband 
determined, quite wisely, that an operation was 
necessary. He proposed to ask a well-known 
surgeon in a neighbouring city to undertake this 
measure. He told his wife, of course, of his 
intention, but she would have none of it. " No," 
she said, " she would not be operated on by stuffy 
old Mr. Heron. ^ He was no good. She could 
not bear him even to touch her. If an operation 
was necessary no one should do it but her 
husband He was so clever, such a surgeon, and 

1 The name is fictitious. 



The Idol with Hands of Clay 189 

so up-to-date. Old Heron was a fossil and behind 
the times. No ! Her clever Jimmy should do 
it and no one else. She could trust no one else. 
In his wonderful hands she would be safe, and 
would be running about again in the garden in 
no time. What was the use of a fine surgeon if 
his own wife was denied his precious help! " 

The husband made no attempt to resist her 
wish. He contemplated the ordeal with dread, 
but was so influenced by her fervid flattery that 
he concealed from her the fact that the prospect 
made him faint of heart and that he had even 
asked himself : '' Can I go through with it.^ " 

He told me afterwards that his miserable 
vanity decided him. He could not admit that he 
lacked either courage or competence. He saw, 
moreover, the prospect of making an impression. 
The town people would say : " Here is a surgeon 
so sure of himself that he carries out a grave 
operation on his owti wife without a tremor." 
Then, again, his assistant would be his fellow- 
practitioner in the town. How impressed he 
would be by the operator's skill, by his coolness, 
by the display of the latest type of instrument, 
and generally by his very advanced methods. It 
was true that it was the first major operation he 
had ever undertaken, but he no longer hesitated. 



igo The Idol with Hands of Clay 

He must not imperil his wife's faith in him nor 
fail to realize her conception of his powers. As 
he said to me more than once, it was his vanity 
that decided him. 

He read up the details of the operation in 
every available manual he possessed. It seemed 
to be a simple procedure. Undoubtedly in nine 
cases out of ten it is a simple measure. His 
small experience, as an onlooker, had been limited 
to the nine cases. He had never met with the 
tenth. He hardly believed in it. The operation 
as he had watched it at the hospital seemed so 
simple, but he forgot that the work of expert 
hands does generally appear simple. 

The elaborate preparations for the operation 
— made with anxious fussiness and much clinking 
of steel — were duly completed. The lady was 
brought into the room appointed for the opera- 
tion and placed on the table. She looked very 
young. Her hair, parted at the back, was 
arranged in two long plaits, one on either side 
of her face, as if she were a schoolgirl. She had 
insisted on a pink bow at the end of each plait, 
pleading that they were cheerful. She smiled as 
she saw her husband standing in the room look- 
ing very gaunt and solemn in his operating dress 
— a garb of linen that made him appear half -monk. 



The Idol with Hands of Clay 191 

half -mechanic. She held her hand towards him, 
but he said he could not take it as his own hand 
was sterilized. Her smile vanished for a moment 
at the rebuke, but came back again as she said : 
"Now don't look so serious, Jimmy; I am not 
the least afraid. I know that with you I am safe 
and that you will make me well, but be sure 
you are by my side when I awake, for I want 
to see you as I open my eyes. Wonderful 
boy! " 

The operation was commenced. The young 
doctor told me that as he cut with his knife into 
that beautiful white skin and saw the blood well 
up behind it a lump rose in his throat and he felt 
that he must give up the venture. His vanity, 
however, urged him on. His doctor friend was 
watching him. He must impress him with his 
coolness and his mastery of the position. He 
talked of casual things to show that he was quite 
at ease, but his utterances were artificial and 
forced. 

For a time all went well. He was showing 
off, he felt, with some effect. But when the 
depths of the wound were reached a condition of 
things was found which puzzled him. Structures 
were confused and matted together, and so 
obscured as to be unrecognizable. He had read 



192 The Idol with Hands of Clay 

of nothing like this in his books. It was the 
tenth case. He became uneasy and, indeed, 
alarmed, as one who had lost his way. He ceased 
to chatter. He tried to retain his attitude of 
coolness and command. He must be bold, he 
kept saying to himself. He made bhnd efforts 
to find his course, became wild and finally reck- 
less. Then a terrible thing happened. There 
was a tear — something gave way — something 
gushed forth. His heart seemed to stop. He 
thought he should faint. A cold sweat broke 
out upon his brow. He ceased to speak. His 
trembling fingers groped aimlessly in the depths 
of the wound. His friend asked : " What has 
happened ? ' ' He replied with a sickly fury : 
"Shut up!" 

He then tried to repair the damage he had 
done ; took up instrument after instrument and 
dropped them again until the patient's body was 
covered with soiled and discarded forceps, knives 
and clamps. He wiped the sweat from his brow 
with his hand and left a wide streak of blood 
across his forehead. His knees shook and he 
stamped to try to stop them. He cursed the 
doctor who was helping him, crying out : " For 
God's sake do this," or " For God's sake don't 
do that ' ' ; sighed like a suffocating man ; looked 



The Idol with Hands of Clay 193 

vacantly round the room as if for help ; looked 
appealingly to his wife's masked face for some 
sign of her tender comfort, but she was more 
than dumb. Frenzied with despair, he told the 
nurse to send for Mr. Heron. It was a hopeless 
mission, since that surgeon — even if at home — 
could not arrive for hours. 

He tried again and again to close the awful 
rent, but he was now nearly dropping with terror 
and exhaustion. Then the anaesthetist said in a 
whisper: "How much longer will you be? Her 
pulse is failing. She cannot stand much more." 
He felt that he must finish or die. He finished 
in a way. He closed the wound, and then sank 
on a stool with his face buried in his blood-stained 
hands, while the nurse and the doctor applied the 
necessary dressing. 

The patient was carried back to her bedroom, 
but he dared not follow. The doctor who* had 
helped him crept away without speaking a word. 
He was left alone in this dreadful room with its 
hideous reminders of what he had done. He 
wandered about, looked aimlessly out of the 
window, but saw nothing, picked up his wife's 
handkerchief which was lying on the table, 
crunched it in his hand, and then dropped it on 
the floor as the red horror of it all flooded his 



194 The Idol with Hands of Clay 

brain. What had he done to her? She! She 
of all women in the world ! 

He caught a sight of himself in the glass. 
His face was smeared with blood. He looked 
inhuman and unrecognizable. It was not himself 
he saw : it was a murderer with the brand of 
Cain upon his brow. He looked again at her 
handkerchief on the ground. It was the last 
thing her hand had closed upon. It was a piece 
of her lying amid this scene of unspeakable 
horror. It was like some ghastly item of 
evidence in a murder story. He could not touch 
it. He could not look at it. He covered it with 
a towel. 

In a while he washed his hands and face, put 
on his coat and walked into the bedroom. The 
blind was down ; the place was almost dark ; the 
atmosphere was laden with the smell of ether. 
He could see the form of his wife on the bed, but 
she was so still and seemed so thin. The coverlet 
appeared so flat, except where the points of her 
feet raised a little ridge. Her face was as white 
as marble. Although the room was very silent, 
he could not hear her breathe. On one side of 
the bed stood the nurse, and on the other side the 
anaesthetist. Both were motionless. They said 
nothing. Indeed, there was nothing to say. 



The Idol with Hands of Clay 195 

They did not even look up when he came in. 
He touched his wife's hand, but it was cold and 
he could feel no pulse. 

In about two hours Heron, the surgeon, 
arrived. The young doctor saw him in an 
adjacent bedroom, gave him an incoherent, 
spasmodic account of the operation, laid emphasis 
on unsurmountable difficulties, gabbled some- 
thing about an accident, tried to excuse himself, 
maintained that the fault was not his, but that 
circumstances were against him. 

The surgeon's examination of the patient was 
very brief. He went into the room alone. As 
he came out he closed the door after him. The 
husband, numb with terror, was awaiting him in 
the lobby. The surgeon put his hand on the 
wretched man's shoulder, shook his head and, 
without uttering a single word, made his way 
dow^n the stairs. He nearly stumbled over a 
couple of shrinking, white-faced maids who had 
crept up the stairs in the hope of hearing some- 
thing of their young mistress. 

As he passed one said : "Is she better, 
doctor? " but he merely shook his head, and 
without a word walked out into the sunny street 
where some children were dancing to a barrel- 
organ. 



196 The Idol with Hands of Clay 

The husband told me that he could not 
remember what he did during these portentous 
hours after the operation. He could not stay in 
the bedroom. He wandered about the house. 
He went into his consulting room and pulled out 
some half-dozen works on surgery with the idea 
of gaining some comfort or guidance ; but he 
never saw a word on the printed page. He went 
into the dispensary and looked over the rows of 
bottles on the shelves to see if he could find any- 
thing, any drug, any elixir that would help. He 
crammed all sorts of medicines into his pocket 
and took them upstairs, but, as he entered the 
room, he forgot all about them, and when he 
found them in his coat a week later he wondered 
how they had got there. He remembered a pallid 
maid coming up to him and saying : " Lunch is 
ready, sir." He thought her mad. 

He told me that among the horrors that 
haunted him during these hours of waiting not 
the least were the flippant and callous thoughts 
that would force themselves into his mind with 
fiendish brutality. There was, for example, a 
scent bottle on his wife's table — a present from 
her aunt. He found himself wondering why her 
aunt had given it to her and when, what she had 
paid for it, and what the aunt would say when 



The Idol with Hands of Clay 197 

she heard her niece was dead. Worse than that, 
he began composing in his mind an obituary 
notice for the newspapers. How should he word 
it.'* Should he say "beloved wife," or "dearly 
loved wife," and should he add all his medical 
qualifications? It was terrible. Terrible, too, 
was his constant longing to tell his wife of the 
trouble he was in and to be comforted by her. 

Shortly after the surgeon left the anaesthetist 
noticed some momentary gleam of consciousness 
in the patient. The husband hurried in. The 
end had come. His wife's face was turned 
towards the window. The nurse lifted the blind 
a little so that the light fell full upon her. She 
opened her eyes and at once recognized her 
husband. She tried to move her hand towards 
him, but it fell listless on the sheet. A smile — 
radiant, grateful, adoring — illumined her face, 
and as he bent over her he heard her whisper : 
"Wonderful boy." 



BREAKING THE NEWS 



XI 

BREAKING THE NEWS 

AMONG the more painful experiences which 
X^m haunt a doctor's memory are the occasions 
on which it has been necessary to tell a patient 
that his malady is fatal and that no measure 
of cure lies in the hands of man. Rarely in- 
deed has such an announcement to be bluntly 
made. In the face of misfortune it is merciless 
to blot out hope. That meagre hope, although 
it may be but a will-o'-the-wisp, is still a glimmer 
of light in the gathering gloom. Very often 
the evil tidings can be conveyed by the lips of 
a sympathetic friend. Very often the message 
can be worded in so illusive a manner as to plant 
merely a germ of doubt in the mind ; which germ 
may slowly and almost painlessly grow into a 
realization of the truth. I remember being 
present when Sir William Jenner was enumerating 
to a friend the qualities he considered to be 
essential in a medical man. "He needs," said 
the shrewd physician, "three things. He must 
be honest, he must be dogmatic and he must be 

N 201 



202 Breaking the News 

kind." In imparting his dread message the 
doctor needs all these qualities, but more especially 
the last — he must be kind. His kindness will be 
the more convincing if he can, for the moment, 
imagine himself in the patient's place and the 
patient in his. 

The mind associates the pronouncing of a 
verdict and a sentence of death with a court of 
justice, a solemn judge in his robes, the ministers 
of the law, the dock, a pallid and almost breath- 
less audience. Such a spectacle, with its elaborate 
dignity, is impressive enough, but it is hardly less 
moving when the scene is changed to a plain 
room, hushed almost to silence and occupied by 
two persons only, the one who speaks and the 
one who listens — the latter with bowed head and 
with knotted hands clenched between his knees. 

The manner in which ill-news is received 
depends upon its gravity, upon the degree to 
which the announcement is unexpected and upon 
the emotional bearing of the recipient. There 
may be an intense outburst of feehng. There 
may be none. The most pitiable cases are those 
in which the sentence is received in silence, or 
when from the trembling lips there merely escapes 
the words, " It has come." 

The most vivid displays of feeling that occur 



Breaking the News 203 

to my mind have been exhibited by mothers when 
the fate of a child is concerned. If her child 
be threatened a mother may become a tigress. 
I remember one such instance. I was quietly 
interviewing a patient in my consulting room 
when the door suddenly flew open and there 
burst in — as if blown in by a gust of wind — a 
gasping, wild-eyed woman with a little girl tucked 
up under her arm like a puppy. Without a word 
of introduction she exclaimed in a hoarse whisper, 
"He wants to take her foot off." This sudden, 
unexplained lady was a total stranger to me. 
She had no appointment. I knew nothing of 
her. She might have dropped from the clouds. 
However, the elements of violence, confusion and 
terror that she introduced into my placid room 
were so explosive and disturbing that I begged 
my patient to excuse me and conducted, or rather 
impelled, the distraught lady into another room. 
Incidentally I may remark that she was young 
and very pretty ; but she was evidently quite 
oblivious of her looks, her complexion, her dress 
or her many attractions. I had before noticed 
that when a good-looking woman is unconscious 
of being good-looking there is a crisis in progress. 
The story, which was told me in gasps and 
at white heat, was as follow. The child was a 



204 Breaking the News 

little girl of about three, almost as pretty as her 
mother. She was the only child and had developed 
tuberculous disease in one foot. The mother had 
taken the little thing to a young surgeon who 
appears to have let fall some rash remark as to 
taking the foot off. This was enough for the 
mother. She would not listen to another syllable. 
She, whom I came to know later as one of the 
sweetest and gentlest of women, changed at the 
moment to a wild animal — a tigress. 

Without a word she snatched up the baby and 
bolted from the house, leaving the child's sock 
and shoe on the consulting-room floor. She had 
been given my name as a possible person to con- 
sult and had dashed off to my house, carrying the 
child through the streets with its bare foot and 
leg dangling in the air. On being admitted she 
asked which was my room. It was pointed out 
to her, and without more ado she flung herself in 
as I have described. The child, I may say, was 
beaming with delight. This dashing in and out 
of other people's houses and being carried through 
the streets without a sock or a shoe on her foot 
struck her as a delicious and exciting game. 

The mother's fury against my surgical colleague 
was almost inexpressible. If the poor man had 
suggested cutting off the child's head he could 



Breaking the News 205 

not have done worse. "How dare he!'* she 
gasped. " How dare he talk of cutting off her 
foot ! If he had proposed to cut off my foot I 
should not have minded. It would be nothing. 
But to cut off her little foot, this beautiful little 
foot, is a horror beyond words, and then look at 
the child, how sweet and wonderful she is ! What 
wickedness!" It was a marvellous display of 
one of the primitive emotions of mankind, a pic- 
ture, in human guise, of a tigress defending her 
cub. By a happy good fortune, after many 
months and after not a few minor operations, the 
foot got well so that the glare in the eyes of the 
tigress died away and she remembered again that 
she was a pretty woman. 

It is well known that the abrupt reception of 
ill-tidings may have a disastrous effect upon the 
hearer. The medical man is aware that, if he 
would avoid shock, the announcement of un- 
pleasant facts or of unhappy news must be made 
slowly and with a tactful caution. In this method 
of procedure I learnt my lesson very early and in 
a way that impressed my memory. 

I was a house-surgeon and it was Christmas 
time. In my day each house-surgeon was on what 
was called " full duty " for one entire week in 
the month. During these seven days all accident 



2o6 Breaking the News 

cases came into his surgeon's wards. He was said 
to be " taking in." On this particular Christmas 
week I was " taking in." Two of my brother 
house-surgeons had obtained short leave for 
Christmas and I had undertaken their duties. It 
was a busy time ; so busy indeed that I had not 
been to bed for two nights. On the eve of the 
third night I was waiting for my dressers in the 
main corridor at the foot of the stair. I was 
leaning against the wall and, for the first and the 
last time in my life, I fell asleep standing up. The 
nap was short, for I was soon awakened, " rudely 
awakened" as novelists would put it. 

I found myself clutched by a heated and pant- 
ing woman who, as she clung to me, said in a 
hollow voice, "Where have they took him?" 
The question needed some amplification. I in- 
quired who "he" was. She replied, "The bad 
accident case just took in." Now the term 
"accident" impUes, in hospital language, a man 
ridden over in the street, or fallen from a scaffold, 
or broken up by a railway collision. I told her 
I had admitted no such case of accident. In fact 
the docks and the great works were closed, and 
men and women were celebrating the birth of 
Christ by eating too much, by getting drunk and 
by street rioting, which acts involved only minor 



Breaking the News 207 

casualties. She was, however, convinced he was 
" took in." He was her husband. She gave me 
his name, but that conveyed nothing, as it was 
the dresser's business to take names. With a 
happy inspiration I asked, " What is he? " "A 
butler," she replied. Now a butler is one of the 
rarest varieties of mankind ever to be seen in 
Whitechapel, and it did so happen that I had, a 
few hours before, admitted an undoubted butler. 
I told her so, with the effusion of one eager to 
give useful information. She said, " What is the 
matter with him?" I replied cheerily, "He 
has cut his throat." 

The effect of this unwise readiness on my part 
was astonishing. The poor woman, letting go 
of my coat, collapsed vertically to the floor. She 
seemed to shut up within herself like a telescope. 
She just went down like a dress dropping from a 
peg. When she was as small a heap as was pos- 
sible in a human being she rolled over on to her 
head on the ground. A more sudden collapse I 
have never seen. Had I been fully awake it would 
never have happened. We placed her on a couch 
and soon restored her to consciousness. 

Her story was simple. She and her husband 
had met. The two being " full of supper and 
distempering draughts " (as BrabantiO would say) 



2o8 Breaking the News 

had had a savage quarrel. At the end he banged 
out of the house, exclaiming, " I will put an end 
to this." She had bawled after him, " I hope to 
God you will." He had wandered to Whitechapel 
and, creeping into a stable, had cut his throat 
there and then. The friend who hastened to in- 
form the wife told her, with a tactfulness I so 
grievously lacked, that her husband had met with 
an accident and had been taken to the hospital. 
This lesson I never forgot and in the future based 
my method of announcing disaster upon that 
adopted by the butler's discreet friend. 

Although a digression from the present subject 
I am reminded of the confusion that occasionally 
took place in the identity of cases. All patients 
in the hospital who are seriously ill, whether they 
have been long in the wards or have been only 
just admitted, are placed on "the dangerous 
list " and have their names posted at the gate 
so that their relatives might be admitted at any 
time of the day or night. 

A man very gravely injured had been taken 
into the accident ward. He was insensible and his 
condition such that he was at once put on the 
dangerous list, or, in the language of the time, 
was " gated." During the course of the evening 
n youngish woman, dressed obviously in her best. 



Breaking the News 209 

bustled into the ward with an air of importance 
and with a handkerchief to her Hps. She de- 
manded to see the man who had been brought 
in seriously injured. She was directed by the 
sister to a bed behind a screen where lay the man, 
still insensible and with his head and much of 
his face enveloped in bandages. The woman at 
once dropped on her knees by the bedside and, 
throwing her arms about the neck of the uncon- 
scious man, wept with extreme profusion and with 
such demonstrations of grief as are observed at 
an Oriental funeral. When she had exhausted 
herself she rose to her feet and, staring at the 
man on the bed, exclaimed suddenly, " This is 
not Jim. This is not my husband. Where is 
he?" 

Now, in the next bed to the one with the 
screen, and in full view of it, was a staring man 
sitting bolt upright. He had been admitted with 
an injury to the knee. This was Jim. He was 
almost overcome by amazement. He had seen 
his wife, dressed in her best, enter the ward, clap 
her hand to her forehead, fall on her knees and 
throw her arms round the neck of a total stranger 
and proceed to smother him with kisses. Jim's 
name had been "gated" by mistake. 

When she came to the bedside of her real 



210 Breaking the News 

husband she was annoyed and hurt, so hurt, in- 
deed, that she dealt with him rudely. She had 
worked herself up for a really moving theatrical 
display in the wards, had rehearsed what she should 
say as she rode along in the omnibus and con- 
sidered herself rather a heroine or, at least, a lady 
of intense and beautiful feeling which she had now 
a chance of showing off. All this was wasted and 
thrown away. An injured knee, caused by falling 
over a bucket, was not a subject for fine emotional 
treatment. She was disgusted with Jim. He had 
taken her in. " Bah! " she exclaimed. " Come 
in with water on the knee ! You might as well 
have come in with water on the brain ! You are 
a fraud, you are ! What do you mean by dragging 
me all the way here for nothing .'' You ought to 
be ashamed of yourself." With this reproof she 
sailed out of the room with great dignity — a 
deeply injured woman. 

To return to the original topic. In all my 
experience the most curious manner in which a 
painful announcement was received was manifested 
under the following circumstances. A gentleman 
brought his daughter to see me — a charming girl 
of eighteen. He was a widower and she was his 
only child. A swelling had appeared in the upper 
part of her arm and was increasing ominously. It 



Breaking the News 211 

became evident on examination that the growth 
was of the kind known as a sarcoma and that the 
only measure to save Hfe was an amputation of 
the limb at the shoulder joint, after, of course, 
the needful confirmatory exploration had been 
made. 

A more distressing position could hardly be 
imagined. The girl appeared to be in good health 
and was certainly in the best of spirits. Her father 
was absolutely devoted to her. She was his ever- 
delightful companion and the joy and comfort of 
his life. Terrible as the situation was it was 
essential not only that the truth should be told 
but told at once. Everything depended upon an 
immediate operation and, therefore, there was not 
a day to be lost. To break the news seemed for 
a moment almost impossible. The poor father 
had no suspicion of the gravity of the case. He 
imagined that the trouble would probably be dealt 
with by a course of medicine and a potent liniment. 
I approached the revelation of the dreadful truth 
in an obscure manner. I discussed generalities, 
things that were possible, difficulties that might 
be, threw out hints, mentioned vague cases, and 
finally made known to him the bare and ghastly 
ti'uth with as much gentleness as I could command. 

The wretched man listened to my discourse 



212 Breaking the News 

with apparent apathy, as if wondering what all 
this talk oould mean and what it had to do with 
him. When I had finished he said nothing, but, 
rising quietly from his chair, walked over to one 
side of the room and looked at a picture hanging 
on the wall. He looked at it closely and then, 
stepping back and with his head on one side, viewed 
it at a few feet distant. Finally he examined it 
through his hand screwed up like a tube. While 
so doing he said, " That is a nice picture. I 
rather Hke it. Who is the artist? Ah! I see his 
name in the corner. I like the way in which he 
has treated the clouds, don't you? The fore- 
ground too, with those sheep, is very cleverly 
managed." Then turning suddenly to me he 
burst out, " What were you talking about just 
now? You said something. What was it? For 
God's sake say that it is not true ! It is not 
true! It cannot be true! " 



A QUESTION OF HATS 



XII 

A QUESTION OF HATS 

I HAD had a very busy afternoon and had 
still two appointments to keep. The first of 
these was in the suburbs, a consultation with 
a doctor who was a stranger to me. It was a 
familiar type of house where we met — classic 
Doric pillars to the portico, a congested hall 
with hat-pegs made of cow horns, a pea-green 
vase with a fern in it perched on a bamboo 
tripod, and a red and perspiring maid-servant. 
Further, I became acquainted with a dining-room 
containing bomb-proof, mahogany furniture, and 
great prints in pairs on the walls, "War" and 
"Peace" on one side, "Summer" and 
"Winter" on the other. Then there was the 
best bedroom, rich in lace and wool mats, con- 
taining a bedstead as glaring in brass as a 
fire-engine, a mirror draped with muslin and 
pink bows, and enough silver articles on the 
dressing-table to start a shop. After a discus- 
sion of the case with the doctor in a drawing-room 

which smelt like an empty church, I rushed off, 

215 



2i6 A Question of Hats 

leaving the doctor to detail the treatment we had 
advised, for I found — to my dismay — that I was 
twenty minutes late. 

The second case was that of an exacting duke 
whom I had to visit at regular periods and, 
according to the ducal pleasure, I should be at 
the door at least one minute before the appointed 
hour struck. I was now hopelessly late and con- 
sequently flurried. On reaching the ducal abode 
I flew upstairs prepared to meet the storm. His 
Grace ignored my apologies and suggested, with 
uncouth irony, that I had been at a cricket 
match. He added that it was evident that I 
took no interest in him, that his sufferings were 
nothing to me, and concluded by asserting that 
if he had been dying I should not have hurried. 
I always regard remarks of this type as a symptom 
of disease rather than as a considered criticism of 
conduct, and therefore had little difficulty in 
bringing the duke to a less contentious frame of 
mind by reverting to that topic of the day — his 
engrossing disorder. 

The duke never allowed his comfort to be in 
any way disturbed. He considered his disease as 
a personal affront to himself, and I therefore 
discussed it from the point of view of an 
unprovoked and indecent outrage. This he found 



A Question of Hats 217 

very pleasing, although I failed to answer his 
repeated inquiry as to why His Grace the Duke 
of X should be afflicted in this rude and offensive 
manner. It was evident that his position should 
have exempted him from what was quite a vulgar 
disorder, and it was incomprehensible that he, 
of all people, should have been selected for this 
insult. 

The inter\iew over, I made my report to the 
duchess, who was in a little room adjacent to the 
hall. She followed me out to ask a final question 
just as I was on the point of taking my hat. 
The hat handed to me by the butler was, how- 
ever, a new hat I had never seen before. It was 
of a shape I disliked. The butler, with due 
submission, said it was the hat I came in. I 
replied it was impossible, and, putting it on my 
head, showed that it was so small as to be 
absurd. The duchess, who was a lady of prompt 
convictions, exclaimed, "Ridiculous; that was 
never your hat ! ' ' The butler could say no 
more : he was convicted of error. The duchess 
then seized upon the only other hat on the table 
and held it at arm's length. " Whose is this? " 
she cried. '' Heavens, it is the shabbiest hat I 
ever saw! It cannot be yours." (It was not.) 
Looking inside, she added, "What a filthy hat! 



2i8 A Question of Hats 

It is enough to poison the house." Handing it 
to the butler as if it had been an infected rag, 
she exclaimed, "Take it away and burn it! " 

The butler did not at once convey this 
garbage to the flames, but remarked — as if talk- 
ing in his sleep — " There is a pianoforte tuner 
in the drawing-room." The duchess stared with 
amazement at this inconsequent remark. Where- 
upon the butler added that the new hat I had 
rejected might possibly be his. He was at once 
sent up to confront the artist, whose aimless 
tinkling could be heard in the hall, with the 
further message that if the dirty hat should 
happen to be his he was never to enter the house 
again. The butler returned to say that the 
musician did not "use " a hat. He wore a cap, 
which same he had produced from his pocket. 

While the butler was away a great light had 
illumined the mind of the duchess. It appeared 
that Lord Andrew, her son-in-law, had called 
that afternoon with his wife. He had just left, 
his wife remaining behind. It was soon evident 
that the duchess had a grievance against her 
son-in-law. When the light fell upon her she 
exclaimed to me, " I see it all now. This 
horrible hat is Andrew's. He has taken yours 
by mistake and has left this disgusting thing 



A Question of Hats 219 

behind. It is just like him. He is the worst- 
dressed man in London, and this hat is just the 
kind he would wear." 

At this moment the daughter appeared. She 
had overheard her mother's decided views, and 
was proportionately indignant. She disdained 
to even look at the hat, preferring to deal with 
the indictment of Andrew on general grounds. 
She defended her husband from the charge of 
being unclean with no little show of temper. 
Without referring to the specific hat, she said 
she was positive, on a priori grounds, that 
Andrew would never wear a dirty hat. Her 
mother had no right to say such things. It was 
unjust and unkind. 

The duchess was now fully roused. She was 
still more positive. This, she affirmed, was just 
the sort of thing Andrew would do — leave an old 
hat behind and take a good one. She would send 
him at once a note by a footman demanding the 
immediate return of my hat and the removal of 
his own offensive headgear. 

The daughter, deeply hurt, had withdrawn 
from the discussion. I suggested that as Lady 
Andrew was about to go home she might inquire 
if a mistake had been made. Her Grace, how- 
ever, was far too moved to listen to such 



220 A Question of Hats 

moderation. She wanted to tell Andrew what 
she thought of him, and it was evident she had 
long been seeking the opportunity. So she at 
once stamped off to write the note. In the 
meanwhile I waited, gazing in great melancholy 
of mind at the two hats. The silent butler also 
kept his eyes fixed upon them with a gloom even 
deeper than mine. I had hinted that the new 
hat might belong to Lord Andrew, but the 
duchess had already disposed of that suggestion 
by remarking with assurance that Andrew never 
wore a new hat. The note was produced and at 
once dispatched by a footman. 

I have no idea of the wording of the note, 
but I was satisfied that the duchess had not been 
ambiguous, and that she had told her son-in-law 
precisely what were her present views of him in 
a wider sense than could be expressed in terms 
of hats. The writing of the letter had relieved 
her. She was almost calm. 

She now told the silent butler to fetch one 
of the duke's hats, so that I might have at least 
some decent covering to my bare head thus 
unscrupulously stripped by the unclean Andrew. 
The butler returned with a very smart hat of the 
duke's. It had apparently never been worn. It 
fitted me to perfection. In this vicarious coronet 



A Question of Hats 221 

I regained my carriage. I felt almost kindly 
towards the duke now that I was wearing his 
best hat. 

Next day I placed the ducal hat in a befitting 
hat-box and, having put on another hat of my 
own, was starting for the scene of the downfall 
of Lord Andrew. At my door a note was handed 
me. It was from the suburban doctor. He very 
courteously pointed out that I had taken his hat 
by mistake, and said he would be glad if I would 
return it at my convenience, as he had no other, 
and my hat came down over his eyes. It was 
a dreadful picture, that of a respected practitioner 
going his rounds with a hat resting on the bridge 
of his nose ; but at least it cleared up the mystery 
of the new hat. The butler was right. In my 
anxiety at being late on the previous afternoon 
I was evidently not conscious that I was wearing 
a hat which must have looked like a thimble on 
the top of an egg. 

On reaching the ducal residence I was received 
by the butler. He said nothing ; but it seemed 
to me that he smiled immoderately for a butler. 
The two hats, the new and the dirty, were still 
on the table, but the duchess made no appear- 
ance. I returned the duke's hat with appropriate 
thanks and expressed regret for the stupid mistake 



222 A Question of Hats 

I had made on the occasion of my last visit. 
I then placed the doctor's new hat I had 
repudiated in the hat-box ready for removal. 

The full mystery was still unsolved, while the 
butler stood in the hall like a hypnotized sphinx. 
I said, in a light and casual way, " And what 
about Lord Andrew? Did his lordship answer 
the note? " The butler replied, with extreme 
emphasis, "He did indeed! " Poor duchess, I 
thought, what a pity she had been so violent and 
so hasty. 

Still the dirty hat remained shrouded in 
mystery, so, pointing to it, I said to the butler, 
" By the way, whose hat is that? " " That hat, 
sir," he replied, adopting the manner of a show- 
man in a museum, "that hat is the duke's. It 
is the hat His Grace always wears when he goes 
out in the morning." " But then," I asked, 
" why did you not tell the duchess so yester- 
day? " He replied, "What, sir! After Her 
Grace had said that the hat was enough to 
poison the house ! Not me ! ' ' 



Printed by Cassell & Compaky, Limited, La Belle Sauvage, London, E.C.4. 

F. 35.1222 



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